Spontaneous extra-hepatic bile duct perforation postpartum

Spontaneous bile duct perforation is an unusual cause of acute abdomen. It is an extremely rare condition and rarely suspected or correctly diagnosed pre-operatively. A case of a 29 year old adult female, presenting with peritonitis, 2 days post partum is presented. Exploratory laparotomy showed biliary peritonitis secondary to a perforated common bile duct. She had a cholecystectomy and closure of the perforation over a T-tube. She recovered well and was discharged home. Awareness of spontaneous common bile duct perforation as a rare cause of biliary peritonitis, avoids undue delay in the diagnosis and thus improve prognosis. Cholecystectomy and drainage of bile duct using a T-tube is emphasized.