Primary Bile Duct Perforation Associated with Pancreatitis

Primary bile duct perforation is rare in adults. It commonly results in biliary peritonitis and high morbidity and mortality. We present a 72-year-old man who was initially admitted with biochemically diagnosed pancreatitis who was found to have a bile duct perforation and bile collection limited to the lesser sac. This presented a diagnostic challenge and, due to its containment, did not result in generalized biliary peritonitis, which is usually associated with this condition. His condition was managed with stenting with endoscopic retrograde cholangiopancreatography.