Spontaneous bile duct perforation in a neonate

Hopper, Leslie; Hao, Scarlett; Rodeberg, David A.; Longshore, Shannon

doi:10.1016/j.epsc.2018.08.003

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…The method has proven useful in accurately diagnosing extrahepatic bile duct leaks preoperatively. Similar case reports from the USA (2018) and India (2016, 2017) further illustrate instances of spontaneous biliary perforation diagnosed through various imaging modalities (8)(9)(10).…”

Section: Discussionmentioning

confidence: 54%

Spontaneous Biliary Duct Perforation: Uncommon Diagnosis Using Cholescintigraphy

Munira,

Rahman,

Parveen

et al. 2024

Bangladesh J. Nuclear Med.

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Spontaneous bile duct perforation causing biliary peritonitis in children is an exceedingly rare occurrence. This condition poses an uncommon and potentially hazardous reason for acute abdominal symptoms. A pre-surgical diagnosis remains a rarity. We present a case of a five-month-old infant displaying gradual fever, jaundice, pale-colored stool, and abdominal distension for 12 days who was referred to NINMAS for a 99mTc-HIDA scan to investigate extrahepatic biliary atresia. The scan unveiled substantial radionuclide activity around the abdominal boundary in 2-hour, 4-hour, and 24-hour views, suggesting abnormal radioactivity in ascitic fluid due to bile leakage. Ultrasonography at NINMAS revealed a contracted gallbladder and moderate ascites. This study reviews and discusses the pathogenesis of this condition. Bangladesh J. Nuclear Med. 26(2): 215-217, 2023

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Section: Discussionmentioning

confidence: 54%

Spontaneous Biliary Duct Perforation: Uncommon Diagnosis Using Cholescintigraphy

Munira,

Rahman,

Parveen

et al. 2024

Bangladesh J. Nuclear Med.

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“…In cases of recurrent abdominal pain, biliary dilatation, obstruction, and abnormal pancreaticobiliary duct confluence, biliary tract hepaticojejunostomy should be performed ( 17 ). Upadhyaya et al ( 36 ) believed that if cholangiography ( via T-tube or magnetic resonance cholangiopancreatography) suggests dilation of the common bile duct, hepaticojejunostomy should be performed to avoid biliary cirrhosis, portal hypertension, recurrent pancreatitis, and cholangiocarcinoma. However, hepaticojejunostomy must be performed after inflammation control.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Clinical Characteristics of Spontaneous Bile Duct Perforation in Children

et al. 2022

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ObjectiveThis study aimed to explore the etiology, clinical features, diagnosis, and treatment of spontaneous bile duct perforation (SBDP) in children.MethodsThe clinical data of children with SBDP who were admitted to Wuhan Children's Hospital between January 2014 and January 2020 were retrospectively analyzed.ResultsIn all, 28 cases of children with SBDP (male, 28.6%; female, 71.4%; male-to-female ratio, 1:2.5; average age, 2.15 years) were analyzed. The most common symptoms were fever (85.7%), nausea and vomiting (78.6%), and abdominal distension (67.9%). Among the 28 patients, 26 (92.9%) had elevated hypersensitive C-reactive protein, 24 (85.7%) had an increased neutrophil percentage, and 22 (78.6%) had raised peripheral blood leukocyte counts. Moreover, 19 patients (67.9%) showed increased serum total bilirubin levels, and 5 (17.9%) showed an elevated conjugated bilirubin level. Abdominal CT examination revealed that the gallbladder wall of patients was thickened with edema, accompanied by gallbladder stenosis and gallbladder mucosa enhancement; furthermore, ascites was found in the abdominal cavity and lesser omental bursa. Twenty-two patients underwent abdominal paracentesis, and 20 (90.9%) of them were exposed to bile-based ascites. Among the 28 patients, four recovered with conservative treatment, whereas the others (85.7%) were surgically treated. Of the twenty-four patients undergoing surgery, the perforation site was found at the union of the hepatic and cystic ducts in 12 patients (50%), no perforation site was observed in 9 patients (37.5%), and a common hepatic duct was observed in 3 patients (12.5%). All 24 patients underwent stage I surgery, and temporary biliary drainage was performed because of severe abdominal inflammation. Cholangiography and enhanced CT revealed an abnormal location of the pancreatic duct joining the bile duct in 64.3% patients. Following surgery, 15 patients underwent hepaticojejunostomy. Subsequently, 3-month to 6-year follow-up (median, 30 months) indicated that the patients recovered well with no serious complications.ConclusionSBDP in children may be associated with pancreaticobiliary malunion (PBM) and congenital weakness of the bile duct wall. However, the clinical manifestations of this condition lack specificity; this limitation can be assisted through diagnosis via abdominal CT and by performing abdominal paracentesis. Once SBDP diagnosis is confirmed, the patient should follow the principles of individualized treatment.

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