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December 6, 1965

Chronic Idiopathic Bile Peritonitis

Author Affiliations

From the departments of surgery, Veterans Administration Hospital and the State University of New York, Downstate Medical Center, Brooklyn.

JAMA. 1965;194(10):1140-1142. doi:10.1001/jama.1965.03090230108038

THE PATHOPHYSIOLOGY and secondary effects of acute bile peritonitis have been well investigated and described, but the literature contains a paucity of reference to the effects of prolonged exposure of the tissues to this irritating substance.

Leakage of bile usually follows surgery or trauma and occasionally infection; however, cases of socalled idiopathic or spontaneous bile peritonitis are also reported at the rate of several each year, particularly in the foreign literature.

We had occasion some months ago to treat a case in which bizarre findings led to investigation and organization of the material in this paper.

Report of a Case  The patient, a 59-year-old Negro man, was admitted to the hospital complaining of soreness of the stomach. He stated that during the previous 31/2 months he had had several episodes of pain in the right lower quadrant of the abdomen, lasting two to three days. He denied trauma, nausea, or

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