Document Detail

Conservative management of spontaneous bile duct perforation in infancy:: case report and literature review.
MedLine Citation:
PMID:  22974619     Owner:  NLM     Status:  In-Data-Review    
Spontaneous bile duct perforation in infants is rare, with less than 150 cases having been reported worldwide. With a highly variable presentation, diagnosis and treatment can prove challenging, and outcomes are not without significant morbidity. We herewith report the case of an 8-week-old male infant with spontaneous bile duct perforation. He initially presented with abdominal sepsis and septated ascites on ultrasound, which was confirmed as bilious on ascitic tap and at diagnostic laparoscopy. Intraoperative cholangiogram demonstrated a localized leak at the junction of the cystic and common bile duct. Conversion to laparotomy was ultimately required with cholecystostomy, and 2 external intraabdominal drains were placed. He was subsequently managed conservatively with 4 weeks external drainage, with a repeat cholangiogram at 6 weeks, demonstrating successful resolution of the leak. The reported case supports the findings of changing practices in the existing literature. We suggest that, in cases of spontaneous bile duct perforation with no distal obstruction, dissection and surgery to the biliary tree are not always required. Conservative management with simple external drainage can have its complications but, as shown here, can be a successful treatment option in terms of healing of perforation.
Maria Virginia Pereira E Cotta; Jennifer Yan; Mina Asaid; Peter Ferguson; Thomas Clarnette
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  47     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1757-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Department of Paediatric Surgery, Monash Medical Centre, Clayton, Victoria 3168, Australia. Electronic address:
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