Cholangitis in a child due to biliary tract anomalies

A 29-month-old child with persistent cholangitis and steatorrhea complicating congenital hepatic fibrosis underwent radiographic evaluation of the biliary tree. Communicating intrahepatic cavernous ectasias were demonstrated by percutaneous transhepatic cholangiography, a procedure deemed safe in children of this age group. Unlike most patients with cholangitis, he had documented steatorrhea and growth failure which resolved following successful treatment with trimethoprim-sulfamethoxazole. Bacteriologic diagnosis was made by direct culture of liver tissue combined with duodenal intubation.