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Huge extrahepatic gallstone on percutaneous transhepatic biliary drainage tip-a pediatric case report
Anna-Maria Odenthal1, Carsten Meyer2, Mark Born3
1Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. anna-maria.odenthal@ukbonn.de.
Insights
A rare complication of pediatric liver transplant biliary stricture treatment, percutaneous transhepatic biliary drainage, is gallstone formation. This case highlights successful treatment with percutaneous transhepatic lithotripsy.
Area of Science:
- Hepatobiliary surgery
- Pediatric gastroenterology
- Interventional radiology
Background:
- Biliary strictures are common post-pediatric liver transplantation.
- Percutaneous transhepatic cholangiography is standard for diagnosis and management.
- Common complications include cholangitis and catheter issues.
Purpose of the Study:
- To report a unique case of gallstone formation after biliary drainage.
- To describe the management of this rare complication.
Main Methods:
- Case report of a 5-year-old girl.
- Diagnosis and treatment of extrahepatic gallstone formation.
- Percutaneous transhepatic lithotripsy was employed.
Main Results:
- Incidental finding of gallstone formation associated with biliary drainage.
- Successful treatment using percutaneous transhepatic lithotripsy.
- Demonstrated a rare but potentially harmful complication.
Conclusions:
- Gallstone formation can occur secondary to percutaneous transhepatic biliary drainage.
- Percutaneous transhepatic lithotripsy is an effective treatment.
- Consider drainage-tip stones if drainage removal is difficult.
Abstract:
Biliary strictures, which are common in the first year after pediatric liver transplantation, are diagnosed and managed with percutaneous transhepatic cholangiography. In children undergoing percutaneous transhepatic cholangiography, early cholangitis is the most common complication while typical catheter-related complications are obstruction, dislodgement, kinking, or fracture. This case report discusses the unique presentation and management of a 5-year-old girl with an incidental percutaneous transhepatic biliary drainage-associated extrahepatic gallstone formation following treatment of biliary stricture after pediatric liver transplantation. It was effectively treated with percutaneous transhepatic lithotripsy. Although this is a rare but potentially harmful complication, in case of resistance at drainage removal, a drainage-tip stone should be excluded by ultrasound or fluoroscopy.
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