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Case Report
Choledocholithiasis as a cause of spontaneous common bile duct perforation: From myths to reality. A case report
1 Clinician, Resident in General Surgery, Pontificia Bolivariana University, Medellín, Colombia
2 Clinician, Specialist in General Surgery, Pablo Tobón Uribe Hospital, Medellín, Colombia
3 Clinician, Specialist in General Surgery and Hepatobiliary Surgery, Pablo Tobón Uribe Hospital, Medellín, Colombia; Hepatobiliary and Liver Transplant Program, Pablo Tobón Uribe Hospital, University of Antioquia, Medellín, Colombia
4 Hepatobiliary and Liver Transplant Program, Pablo Tobón Uribe Hospital, University of Antioquia, Medellín, Colombia
5 Gastrohepatology Research Group, University of Antioquia, Medellín, Colombia
Address correspondence to:
Camila Arias González
Resident in General Surgery, Pontificia Bolivariana University, Medellín,
Colombia
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Article ID: 100156Z12CG2025
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How to cite this article
González CA, Gómez PMJ, Ospina DAG, Garcés ÁAD, Duque SIH. Choledocholithiasis as a cause of spontaneous common bile duct perforation: From myths to reality. A case report. J Case Rep Images Surg 2025;11(1):42–46.ABSTRACT
Introduction: Spontaneous common bile duct (CBD) perforation is a rare complication of choledocholithiasis. Typically, it is diagnosed during surgery, particularly exploratory laparotomy, in patients experiencing acute abdomen.
Case Report: We present a case of a 16-year-old female with no prior medical history except for a cesarean section two months prior, who presented to the emergency department with abdominal pain. During surgery, we diagnosed spontaneous common bile duct (CBD) perforation due to choledocholithiasis and described the treatment.
Conclusion: Due to its low incidence, diagnosis of spontaneous CBD perforation is often delayed, leading to increased morbidity and mortality. Symptoms vary, and diagnostic imaging is nonspecific. Treatment choice between conservative and surgical approaches depends on patient hemodynamic stability, perforation characteristics, and CBD condition. Surgical options include bile duct repair or reconstruction. Spontaneous CBD perforation is rare and usually diagnosed during surgery. Treatment ranges from conservative measures to bile duct reconstruction.
Keywords: Choledocholithiasis, Common bile duct, Spontaneous perforation
SUPPORTING INFORMATION
Author Contributions
Camila Arias González - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Paula María Jaramillo Gómez - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
David Alejandro González Ospina - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Álvaro Andrés Duarte Garcés - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Sergio Iván Hoyos Duque - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Camila Arias González et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
