CALCULOUS PANCERATITIS DISCOVERED IN AN AGED PATIENT AFTER GALLBLADDER RUPTURE -A CASE REPORT-

Gallbladder rupture is a probable cause of acute abdomen and, especially in the aged, often constitutes a serious condition. We experienced a case of gallbladder rupture in an aged patient, which might be affected by stenosis of the common bile duct associating with calculous pancreatitis. An 84-year-old man, who was an inpatient under examination for upper abdominal pain of unknown origin, suddenly developed severe pain of the abdomen and abdominal distension. Ultrasonic-guided puncture of ascites revealed the presence of bile juice. Emergency operation was performed and the patient was diagnosed as acute biliary peritonitis secondary to ruptured gallbladder. Intraoperative cholangiography disclosed a stenosis of the lower bile duct. Cholecystectomy and placement of an indwelling T-tube were performed. On the basis of postoperative studies a diagnosis of lower bile duct stenosis due to calculous pancreatitis was made, and at reoperation removal of the calculous and choledochojejunostomy were carried out with favorable results.