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Ischemic gallbladder perforation in a premature infant

Ying-Yi Lu1, Hong-Shiee Lai, Wu-Shiun Hsieh

  • 1Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.

Journal of Pediatric Surgery
|June 19, 2008
PubMed

Insights

Gallbladder perforation is a rare infant condition. This case highlights ischemic gallbladder perforation in a premature infant with complex congenital heart disease, emphasizing unique clinical presentations and outcomes.

Area of Science:

  • Neonatal surgery
  • Pediatric gastroenterology
  • Infant critical care

Background:

  • Gallbladder perforation is exceedingly rare in neonates.
  • Infants with complex congenital heart disease and renal failure are at increased risk.
  • This study details a unique case in a premature infant.

Observation:

  • A premature infant with congenital heart disease and renal failure developed gallbladder perforation at 60 days.
  • Clinical presentation lacked typical signs of peritonitis or liver dysfunction.
  • Bile drainage from peritoneal dialysis tubing was the key indicator.

Findings:

  • Emergent laparotomy revealed a 3-mm gallbladder perforation with necrosis at the neck.
  • Histologic examination confirmed ischemic changes as the cause.
  • Cholecystectomy was successful, with no post-operative biliary complications.

Implications:

  • This case expands the understanding of gallbladder perforation etiology in neonates.
  • Highlights the importance of considering unusual diagnoses in critically ill infants.
  • Underscores the challenges in managing multiple organ failure in this population.

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