Abstract
A case of massive bile peritonitis due to spontaneous slough of the junction of the cystic, common, and common hepatic ducts in a 5-wk-old male infant is reported. This was managed successfully by a Roux-en-Y jejunal anastomosis to the remnant of common hepatic duct. Subsequent ascites (4 mo postoperatively) was relieved by peritoneovenous drainage by a Holter valve from the peritoneal cavity to the right atrium. Comments are made relative to an etiologic commonality between spontaneous perforation of the bile ducts in infancy, “congenital” choledochal cyst, and biliary atresia and a possible role for birth-acquired viral infection, particularly with a herpes type of virus, in these disorders.
Published Version
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