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Spontaneous biliary perforation: a rare entity in late infancy and childhood

Shyam B Sharma1, Sharad C Sharma, Vipul Gupta

  • 1Department of Neonatal and Pediatric Surgery, SMS Medical College, S.P. Mother & Child Health Institute, Jaipur, India.

Indian Journal of Pediatrics
|December 3, 2003
PubMed

Insights

Spontaneous biliary tract perforation is a rare condition in children. This report details two pediatric cases, highlighting successful management through simple drainage or cholecystostomy with external biliary drainage.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Case Reports

Background:

  • Spontaneous perforation of the biliary tract is an exceedingly rare condition in pediatric patients, with limited documented cases in medical literature.
  • This condition often presents with non-specific symptoms mimicking acute peritonitis, posing diagnostic challenges in infants and young children.

Observation:

  • Two pediatric cases are presented: a 9-month-old boy and a 2-year-old boy, both exhibiting symptoms of acute peritonitis.
  • Diagnostic laparotomy revealed sterile biliary peritonitis. One infant had a normal cholangiogram, while the other demonstrated clear biliary perforation.

Findings:

  • Initial management involved simple drainage for the infant with a normal cholangiogram.
  • The second child underwent cholecystostomy with external biliary drainage, leading to a satisfactory clinical outcome in both cases.

Implications:

  • These cases underscore the importance of considering spontaneous biliary perforation in the differential diagnosis of acute peritonitis in children.
  • Prompt surgical intervention, tailored to the specific findings, can lead to favorable outcomes in this rare pediatric surgical emergency.

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