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Idiopathic biliary perforation in a 10-year-old boy

Erica Makin1, Mark Davenport

  • 1Department of Paediatric Surgery, King's College Hospital, Denmark Hill, SE5 9RS London, UK.

Pediatric Surgery International
|February 2, 2006
PubMed

Insights

A rare case of common bile duct perforation occurred in a child with AIDS and Hodgkin's lymphoma. Surgical biliary diversion successfully resolved the bile duct pathology.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatobiliary Surgery
  • Oncology

Background:

  • This report details a unique pediatric case involving a 10-year-old boy with advanced Acquired Immunodeficiency Syndrome (AIDS) and Stage IV Hodgkin's lymphoma.
  • The patient presented with acute abdominal symptoms necessitating urgent medical and surgical intervention.

Observation:

  • The primary clinical observation was bile ascites secondary to a spontaneous perforation of the common bile duct.
  • This rare complication occurred in the context of significant co-morbidities, including advanced HIV/AIDS and Stage IV Hodgkin's lymphoma.

Findings:

  • Initial management involving laparotomy, external peritoneal drainage, and endoscopic biliary stenting proved unsuccessful in resolving the perforation.
  • A subsequent laparotomy with Roux-en-Y hepaticojejunostomy resulted in satisfactory resolution of the common bile duct pathology.

Implications:

  • This case highlights a previously unreported complication of biliary perforation in the setting of AIDS and Hodgkin's lymphoma.
  • The successful management underscores the potential role of surgical biliary diversion in complex hepatobiliary emergencies in immunocompromised pediatric patients.

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