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Ultrasound-guided percutaneous cholecystostomy for acute neonatal biliary obstruction
Radley Helin1, Rama Bhat, Bhaskara Rao
1Department of Pediatrics, University of Illinois Medical Center, Chicago, IL 60612, USA. rhelin1@uic.edu
Insights
Percutaneous cholecystostomy effectively treated acute hyperbilirubinemia in an infant with biliary obstruction. This minimally invasive procedure offers a viable alternative for non-surgical candidates, reducing bilirubin levels.
Area of Science:
- Pediatric Gastroenterology
- Interventional Radiology
Background:
- Acute hyperbilirubinemia in infants can result from biliary tract obstruction.
- Surgical intervention is often the standard treatment but may not be suitable for all patients.
Observation:
- An infant presented with acute extrahepatic biliary tract obstruction and severe conjugated hyperbilirubinemia.
- The infant was deemed an unsuitable candidate for surgical correction.
Findings:
- Ultrasound-guided percutaneous cholecystostomy was successfully performed.
- The procedure led to a rapid, significant, and sustained decrease in serum bilirubin levels.
Implications:
- Percutaneous cholecystostomy is a potentially effective treatment for acute hyperbilirubinemia in infants with biliary obstruction.
- This minimally invasive approach may be a valuable option for non-surgical pediatric patients.
- Further investigation into indications, risks, and benefits is warranted.
Abstract:
Use of a percutaneously-inserted cholecystostomy drainage tube is an effective therapeutic option for acute hyperbilirubinemia in severely-ill adult patients, but to our knowledge has not been previously reported in infants. We describe an infant who developed acute extrahepatic biliary tract obstruction with marked conjugated (direct) hyperbilirubinemia, and who was determined to be an unsuitable surgical candidate. Ultrasound-guided percutaneous cholecystostomy was performed and resulted in prompt, significant, and sustained decline in serum bilirubin levels. Potential risks and benefits, as well as suggested indications for the procedure are discussed.
