A Case of Bile Peritonitis Caused by Intrahepatic Bile Duct Rupture in a 91-year-old Woman

Key Points

• This case aims to highlight the diagnosis and management of bile peritonitis due to intrahepatic bile duct rupture in a very elderly patient.
• Patient presented with upper abdominal pain and abdominal distention.
• Blood tests indicated inflammation and elevated liver enzymes.
• CT scan showed intrahepatic bile duct dilation, biliary stones, and ascites.
• Diagnostic ascitic tap confirmed biliary ascites, leading to the diagnosis of bile peritonitis.
• Emergency laparotomy performed to repair the ruptured bile duct.
• Surgical findings included a ruptured intrahepatic bile duct.
• Surgical procedures included bile duct repair, cholecystectomy, and drain placement.
• Postoperative endoscopic removal of biliary stones occurred.
• The patient was discharged 31 days post-surgery.
• Early surgical intervention was crucial for a favorable outcome.