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Cholelithiasis with common bile duct obstruction in a 20-week-old infant
1Department of General and Thoracic Surgery, Christian-Albrechts-Universität, Kiel, Germany.
Summary
Bile duct stones are rare in infants. This case highlights a 20-week-old infant with anal atresia who experienced jaundice from a common bile duct stone, successfully treated with endoscopic retrograde cholangiography and papillotomy.
Area of Science:
- Pediatric Gastroenterology
- Hepatobiliary Surgery
Background:
- Bile duct stone formation (choledocholithiasis) is uncommon in neonates and infants.
- Infants with congenital anomalies, such as anal atresia and rectovaginal fistula, may have unique presentations of biliary tract disease.
Observation:
- A 20-week-old infant presented with recurrent jaundice.
- The jaundice was attributed to a single common bile duct calculus causing intermittent obstruction of the papilla of Vater.
- The infant had a history of anal atresia and a deep rectovaginal fistula.
Findings:
- Endoscopic retrograde cholangiography confirmed the presence of a common bile duct stone.
- The calculus was successfully removed via transduodenal papillotomy using a Dormia basket.
Implications:
- This case underscores the importance of considering choledocholithiasis in jaundiced infants, even those with complex congenital anomalies.
- Minimally invasive endoscopic techniques can be effective for managing bile duct stones in the pediatric population.
- Early diagnosis and intervention are crucial to prevent complications associated with biliary obstruction.