Urinary and Serum Bile Acids in Bile Peritonitis

Serum or urinary bile acids were determined in bile peritonitis with emphasis on peritoneal bile acid absorption. Bile peritonitis patients consisted of each two patients with insidious type, and acute or dramatic type, of bile peritonitis. All of them exhibited elevation in bile acid concentrations of 95.3, 37.0 mg/liter urine in the former, and of 87.6, 12.8 mg/liter serum in the latter. This finding implies that intraperitoneal bile acids were absorbed through the peritoneum into the blood resulting in hypercholanemia and hypercholanuria, in bile peritonitis. Early diagnosis of bile peritonitis is sometimes difficult because there are fewer signs of peritoneal irritation. Therefore our data indicate that enzymatic determination for serum bile acids is effective for early detection of bile peritonitis and thus the fatal outcome in insidious type of bile peritonitis can be avoided.