Choledocholithiasis as a cause of spontaneous common bile duct perforation: From myths to reality. A case report

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.