A Case Report of Congenital Extrahepatic Duct Dilatation Initially Presenting as Idiopathic Perforation of the Biliary Tract in Childhood

A 3-year-old boy was admitted to our hospital in August 1979, complaining of vomiting and abdominal pain for one week. Five days later he was slightly jaundiced and his abdomen was very distended. At surgery, a large amourt of bile-stained ascitic fluid was removed and a small perforation was found in the wall of the posterior segmental duct that was exposed extrahepatically. Two weeks later, cholangiography through an indwelling 1-tube catheter showed dilatation of the anterior and the posterior segmental ducts and the left hepatic duct. Nine years after the operation cholangiograms obtained by ERCP still showed markedly dilated left hepatic and lateral segmental ducts. The findings in the dilated extrahepatic bile ducts were similar to those described in cases of intrahepatic calculi. But the stone was not in the bile duct at the time of ERCP examination.