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Bile duct perforation in children: is it truly spontaneous?

T R Sai Prasad1, Chan Hon Chui, Yee Low

  • 1Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore. trsai@rediffmail.com

Annals of the Academy of Medicine, Singapore
|January 16, 2007
PubMed

Insights

Bile duct perforation (BDP) in children, often linked to anomalous pancreaticobiliary union (AUPBD) and choledochal cysts, requires surgical intervention. Early diagnosis and treatment are crucial for successful outcomes in these rare cases.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Anatomical Abnormalities

Background:

  • Bile duct perforation (BDP) with biliary ascites is a rare pediatric condition.
  • Anomalous union of the pancreaticobiliary ductal (AUPBD) system is increasingly implicated in BDP aetiopathogenesis.

Observation:

  • Presents two pediatric cases of spontaneous bile duct perforation, histopathologically diagnosed as choledochal cysts.
  • Patients, a 6-month-old female and a 4-year-old boy, exhibited subtle clinical symptoms.

Findings:

  • Both patients underwent successful surgical management involving excision of the gallbladder and common bile duct with Roux-en-Y hepaticojejunostomy.
  • One patient initially received cholecystostomy drainage before definitive surgery.

Implications:

  • Suggests BDP in children may be associated with AUPBD and choledochal cysts, challenging the notion of purely spontaneous perforation.
  • Highlights the importance of considering these underlying conditions in the diagnosis and management of pediatric BDP.
Abstract

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