Spontaneous perforation of the common hepatic duct: a new presentation

A case is reported of spontaneous perforation of the common hepatic duct in a patient presenting with a six-day history of painless jaundice and a one-day history of nausea and vomiting. An endoscopic retrograde cannulation of the common bile duct revealed a large stone in the distal end of the grossly dilated biliary tree. At operation a large collection of bile, sealed off by omentum, was found beneath the liver. A perforation was present in the common hepatic duct close to its junction with the cystic duct.