[Spontaneous rupture of aberrant bile ducts in choledocholithiasis]

It is reported on 4 patients aged 69 to 79 years suffering from rupture of aberrant subserosal bile ducts. In the first patient the gallbladder did not obtain stones, the common duct stones causing increased pressure in the intrahepatic ducts and rupture were not diagnosed, the supposed "cyst" was excised, followed by suture of the liver tissue. Due to peritonitis relaparotomy had to be done. Since now intrahepatic obstruction was supposed a hepatojejunostomy was performed. The patient died from peritonitis following insufficiency of the anastomosis and bronchopneumonia. The other patients were cured by cholecystectomy, revision of the duct, T-tube and suture at the site of perforation, in one case with additional endoscopic papillotomy.