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Spontaneous biliary perforation presenting as gastric outlet obstruction
V Kumar1, A Chattopadhyay, N Bhat
1Department of Pediatric Surgery, Kasturba Medical College, Manipal, Karnataka, India.
Indian Journal of Pediatrics
|May 24, 2001
Summary
Spontaneous biliary perforation (SBP) in neonates is rare, typically causing jaundice. This case highlights an unusual SBP presentation mimicking gastric outlet obstruction, successfully treated with surgery.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Biliary tract disorders
Background:
- Spontaneous biliary perforation (SBP) is a rare neonatal surgical emergency.
- Commonly presents as jaundice with biliary ascites or peritonitis.
- Accurate preoperative diagnosis can be challenging.
Observation:
- This report details a neonate with SBP presenting atypically with gastric outlet obstruction symptoms.
- The unusual presentation led to a preoperative diagnostic error.
- This is the first reported case of SBP mimicking gastric outlet obstruction.
Findings:
- Surgical exploration revealed spontaneous biliary perforation.
- A bilio-enteric bypass and subhepatic space drainage were performed.
- The neonate experienced prompt symptom resolution post-surgery.
Implications:
- Highlights the importance of considering rare diagnoses in neonatal surgical emergencies.
- Suggests SBP can present with varied clinical manifestations beyond typical biliary signs.
- Emphasizes the effectiveness of surgical intervention for SBP with unusual presentations.