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Published on: April 30, 2019
Asymptomatic Bile Duct Dilatation in Children: Is It a Disease?
Yeo Ju Son1, Mi Jung Lee2, Hong Koh1
1Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Insights
Pediatric bile duct dilatation often resolves spontaneously in asymptomatic children. Further investigation is needed for symptomatic cases or those with abnormal findings, as these may indicate underlying biliary disease.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Hepatobiliary Diseases
Background:
- Bile duct dilatation is a common finding on pediatric ultrasonography.
- Its clinical significance in children remains controversial due to limited research.
Purpose of the Study:
- To investigate the natural course and clinical significance of biliary duct dilatation in pediatric patients.
- To differentiate between benign and pathological causes of bile duct dilatation.
Main Methods:
- Retrospective analysis of 181 pediatric patients (1 day to 17 years) with biliary duct dilatation detected via ultrasonography.
- Review of laboratory results, clinical manifestations, and patient outcomes.
Main Results:
- 181 pediatric patients were divided into two groups: 59 without a definitive cause (no treatment required) and 122 with a definitive cause or biliary disease (treatment required).
- In the first group, 40.7% showed spontaneous resolution, 33.9% had no change, and 25.4% were lost to follow-up.
- The second group included 31 cases of choledochal cysts and 91 cases of secondary dilatation due to gallbladder/liver disease, post-operative issues, or malignancy.
Conclusions:
- Pediatric biliary dilatation without symptoms or abnormalities follows a benign course.
- No pathological conditions were identified on follow-up ultrasonography in asymptomatic children.
Purpose:
Bile duct dilatation is a relatively common sonographic finding; nevertheless, its clinical significance in children is controversial because little research has been done in the area. Therefore, we investigated the natural course and clinical significance of biliary duct dilatation in children.
Methods:
We performed a retrospective study of 181 children (range, 1-day-old to 17-year-old) in whom dilatation of the intrahepatic duct and/or common hepatic duct and/or common bile duct was detected by abdominal ultrasonography at the Severance Children's Hospital between November 2005 and March 2014. We reviewed and analyzed laboratory test results, clinical manifestations, and clinical course in these patients.
Results:
Pediatric patients (n=181) were enrolled in the study and divided into two groups. The first group included 59 subjects, without definitive cause of bile duct dilatation, who did not require treatment; the second group included 122 subjects, with definitive cause of bile duct dilatation or underlying biliary disease, who did require treatment. In the first group, 24 patients (40.7%) showed spontaneous resolution of bile duct dilatation, 20 patients (33.9%) showed no change, and 15 patients (25.4%) were lost to follow-up. In the second group, 31 patients were diagnosed with choledochal cysts, and 91 patients presented with biliary tract dilatations due to secondary causes, such as gallbladder or liver disease, post-operative complications, or malignancy.
Conclusion:
Biliary dilatation in pediatric patients without symptoms, and without laboratory and other sonographic abnormalities, showed a benign clinical course. No pathologic conditions were noted on follow-up ultrasonography.
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