Non-traumatic intra-hepatic rupture of the biliary tree. Report of a case.

Non-traumatic extra-hepatic rupture (NTEHR) of the bile system into free peritoneal cavity is a well-known condition. Usually the gall-bladder is the site of perforation, but non-traumatic perforation of the common bile duct and the hepatic duct occurs. For the hepatic duct it is extremely rare and has so far been reported in only 7 cases in adults (Christensen, Baekgaard & Blichert-Toft, 1977; MacWilliams, 1912; Reich, 1942). A review of the literature reveals, that non-traumatic intra-hepatic rupture (NTIHR) in the biliary tree with perforation into free peritoneal cavity has apparently never been reported before. The purpose of this paper is to report two such cases with recovery.