Rezumat Coleperitoneu prin rupturã de cãi biliare intrahepatice - prezentare de caz Perforaåiile netraumatice ale cãilor biliare extrahepatice sunt entitãåi rar întâlnite, cu atât mai mult cele ce afecteazã cãile biliare intrahepatice, exteriorizându-şi conåinutul biliar în marea cavitate peritonealã. Prezentarea unui astfel de caz a determinat autorii sã facã o atentã trecere în revistã a cazurilor prezente în literaturã. Se contureazã faptul cã obstrucåia cãii biliare principale de cauzã litiazicã determinã, prin creşterea presiunii, dilatarea arborelui biliar, stazã şi infecåie urmate de tromboza vaselor intramurale ce duce la perforaåia canalelor biliare, totul pe fondul unor malformaåii necunoscute ale cãilor biliare intrahepatice. Cuvinte cheie: peritonitã biliarã, duct biliar intrahepatic, rupturã spontanã. Abstract Non-traumatic perforations of the bile ducts are unfrequently encountered entities, all the more when they affect the intra- hepatic bile ducts, exteriorizing their biliary content in the great peritoneal cavity. Reporting such a case has determined the authors to perform a careful overview of the cases present in the literature. An observation that can be made based on these is that the obstruction of the main bile duct due to lithiasis determines, by pressure increase, the dilation of the bile system branches, all on the background of an unknown malformation of the intrahepatic bile ducts. Key words: biliary peritonitis, intrahepatic bile duct, spontaneous rupture. Introduction Introduction Congenital dilations of the intra- and extrahepatic bile ducts present a great anatomical diversity and, therefore, their clinical expression is also very variable. Malformations are autosomal recessively transmitted and can affect, according to the classifications of Alonso-Lej and Todani: 1. the intra- hepatic bile ducts exclusively - Caroli disease; 2. the main hepato-choledochal duct; 3. complex and various associations of the first two variants. Most cases occur in childhood or adolescence, but there are cases with severe manifestations (peritonitis) which are clinically expressed in adults. Biliary peritonitis through intrahepatic bile duct rupture is rare, very few cases having been reported in the literature (1,2). These rare forms of peritonitis are unfortunately accompanied by high mortality, up to 50%, despite the recommended surgical treatment and postoperative intensive reanimation (3). Further on we will be presenting a clinical case exemplifying the need of a complete and detailed exploration of the biliary tract in case of choleperitoneum, as well as the Choleperitoneum due to Intrahepatic Bile Duct Rupture - Case Report L. Simion, D.N. Straja, V.M. Prunoiu, M. Alecu, E. Brãtucu First General Surgery and Oncology Department, “Al. Trestioreanu” Oncological Institute, Bucharest, Romania Chirurgia (2014) 109: 542-545 No. 4, July - August Copyright© Celsius Corresponding author: Assistant Professor Dan Nicolae Straja First General Surgery and Oncology Clinic 252 Fundeni Road, Bucharest, sector 2 zip code 22328, Romania E-mail: lasimion@yahoo.com