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Article
July 1954

BILE PERITONITIS DUE TO SPONTANEOUS PERFORATION OF THE COMMON DUCT

Author Affiliations

PLAINFIELD, N J.
Chief, Surgical Service, and former Ward Surgeon, Veterans Administration Hospital, Lyons. N. J.

AMA Arch Surg. 1954;69(1):77-80. doi:10.1001/archsurg.1954.01270010079011
Abstract

BILE PERITONITIS due to a spontaneous perforation of the common duct without antecedent history of trauma, previous surgery or obstructive calculi is exceedingly rare. Spontaneous perforation of the common bile duct in this category has been reported at infrequent intervals, possibly due to one cause or to a combination of causes which include (a) increased intraductal pressure due to spasm of the sphincter of Oddi; (b) intramural infection; (c) diverticulum; (d) necrosis of the part of the wall due to a mural vessel thrombosis; (e) necrosis of the wall secondary to a calculus, and (f) reflux pancreatic secretions and tissue digestion.* As early as 1912, McWilliams1 reviewed 90 cases of bile peritonitis due to spontaneous rupture of the biliary tract of all causes and showed that 91% occurred in the gall bladder, 4.4% in the common duct, 3.3% in the cystic duct, and 1.1% in the hepatic duct. This

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