IN 1882, JOHN FREELAND5 described the first case of nontraumatic perforation of the common hepatic duct. Since then, only eight cases have been reported. When confronted with two cases within a six-month period at St. Luke's Hospital, we felt that a report of these two cases and a brief review of the previously reported cases would be of special interest.
Report of Cases
(No. 44-64-30): A 56-year-old male was admitted to St. Luke's Hospital with abdominal pain of ten hours' duration. In 1939 the patient had a plication of a perforated duodenal ulcer, followed by a subtotal gastric resection in 1952. He was apparently well until the morning of admission when he was awakened with severe midabdominal pain associated with vomiting of bile-stained material. There were no other gastrointestinal symptoms. The past history was significant in that pulmonary tuberculosis was suspected in 1952.The patient was a well-developed, thin