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Spontaneous neonatal gall bladder perforation.

L Nambirajan1, V V Chandrasekharam, A K Gupta

  • 1Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi-110 029, India.

Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation
|February 24, 2001
PubMed
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A neonate developed gastric outlet obstruction after surgery for diaphragmatic eventration. A gallbladder perforation caused a biloma, which was successfully treated with drainage and temporary cholecystostomy.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Neonatal Care

Background:

  • Diaphragmatic eventration is a congenital condition requiring surgical intervention.
  • Postoperative complications can arise, necessitating prompt diagnosis and management.
  • Gastric outlet obstruction presents a critical challenge in neonates.

Observation:

  • A full-term neonate underwent thoracic surgery for diaphragmatic eventration.
  • Postoperatively, the infant presented with symptoms of gastric outlet obstruction.
  • Imaging studies, including ultrasonography and barium meal, indicated extrinsic compression near the pylorus.

Findings:

  • Laparotomy revealed a perforated gallbladder forming a biloma compressing the pylorus.
  • The biloma was successfully drained, and a temporary cholecystostomy was performed.

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  • These interventions resolved the gastric outlet obstruction.

    • Implications:

    • This case highlights a rare but serious complication of diaphragmatic eventration surgery.
    • Prompt recognition and surgical management of biloma-induced gastric outlet obstruction are crucial for neonatal outcomes.
    • Gallbladder complications should be considered in the differential diagnosis of neonatal gastric outlet obstruction post-abdominal surgery.