Neonatal sepsis presenting as a choledochal cyst

Area of Science:

• Neonatal Medicine
• Pediatric Gastroenterology
• Infectious Diseases

Background:

• Neonatal sepsis is a serious condition requiring prompt diagnosis and management.
• Choledochal cysts are congenital biliary tract malformations that can present with various complications.
• Distinguishing sepsis-induced biliary changes from congenital anomalies is clinically important.

Observation:

• A neonate presented with Klebsiella sepsis and ultrasound findings suggestive of a Type Ia choledochal cyst, including fusiform common bile duct dilation.
• Biliary sludge was also observed within the gallbladder.
• All observed biliary abnormalities resolved completely following successful sepsis treatment.

Findings:

• The case highlights that neonatal sepsis can lead to transient biliary tract abnormalities mimicking choledochal cysts.
• Resolution of ductal dilation and sludge post-sepsis suggests a reversible, non-congenital etiology.
• This challenges the assumption that such findings invariably represent a structural anomaly.

Implications:

• In neonates presenting with sepsis and apparent choledochal cysts, serial ultrasounds after sepsis resolution are crucial.
• Repeat imaging can help avoid unnecessary surgical intervention for sepsis-induced biliary changes.
• This approach optimizes patient management and reduces healthcare costs.