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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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A Unique Presentation of Acute Biliary Ascites Due to Spontaneous Biliary Duct Perforation With Bowel Obstruction: A

Vivek R Velagala1, Aayushi Bhatnagar1, Jayant D Vagha2

  • 1Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Cureus
|July 8, 2024
PubMed

Insights

This case report details a rare instance of biliary ascites in a 14-month-old, highlighting the importance of early, non-surgical diagnosis and treatment for improved outcomes in pediatric patients.

Area of Science:

  • Pediatric Gastroenterology
  • Abdominal Surgery

Background:

  • Biliary ascites from spontaneous biliary duct perforation is rare in children.
  • Typically observed in infants aged 6-36 months.

Observation:

  • A 14-month-old presented with abdominal distention, pain, vomiting, fever, and constipation.
  • Radiology revealed free fluid, bowel obstruction, and partial situs inversus.
  • Diagnostic paracentesis confirmed bilious ascites.

Findings:

  • Bowel obstruction was resolved with rectal stimulation.
  • The patient was treated with antibiotics and fluid drainage.
  • Non-surgical diagnosis and early intervention are crucial.

Implications:

  • This case underscores the significance of prompt diagnosis and conservative management in critical pediatric cases.
  • Early detection can significantly improve patient prognosis.
  • Highlights the need for considering rare causes of abdominal symptoms in infants.

Keywords:
abdominal distentionabdominal paracentesisbiliary ascitesbiliary peritonitisbowel obstructionpartial situs inversusperitoneal irritationroux-en-y hepaticojejunostomyspontaneous biliary duct perforationsubcapsular abscess

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