Spontaneous bile duct perforation in a toddler: A rare case

Year 2023, Volume: 40 Issue: 4, 795 - 797, 03.01.2024

Eda Kopru , İlkay Çamlıdağ

Abstract

Spontaneous bile duct perforation is rare in all periods of life. It is rarely detected and managed preoperatively. Some of causes are congenital malformations, cholelithiasis, obstruction and operation. Clinical presentation isn’t specific and the management should be based on patient’s condition. We herewith report a case of a 3-year-old girl with spontaneous bile duct perforation. She admitted with abdominal tenderness, fatigue, loss of appetite and episodes of vomiting. Radiologic images revealed intra and extra hepatic bile duct dilation with free intraperitoneal fluid accumulation without any extrahepatic obstructive lesion, and which was managed conservatively. Adequate management of this condition requires an awareness of its symptoms and radiological findings, appropriate investigation to treat symptoms and site of perforation.

Keywords

spontaneous, biliary duct, perforation, dilatation

References

• 1.Duminda Subasinghe, Edippuli Arachchige Don Udayakumara, Upul Somathilaka, Mil-inda Huruggamuwa, "Spontaneous Perfora-tion of Common Bile Duct: A Rare Presenta-tion of Gall Stones Disease", Case Reports in Gastrointestinal Medicine, vol. 2016, Article ID 5321304,3pages,2016. https://doi.org/10.1155/2016/5321304
• 2.Evans K, Marsden N, Desai A. Spontaneous perforation of the bile duct in infancy and childhood: a sys tematic review. J Pediatr Gastroenterol Nutr. 2010 Jun;50(6):677-81. doi: 10.1097/MPG.0b013e3181d5eed3. PMID: 20400907.
• 3.Leslie Hopper, Scarlett B.Hao ,David Rodeberg,ShannonLongshore.Spontaneous bile duct perforation in a neonate. Journal of Pediatric Surgery Case Reports. Volume 38, November 2018, Pages 57-60
• 4.Kobayashi, Katsutoshi, et al. Bile peritonitis due to spontaneous perforation of the left hepatic duct: A case report. JAPAN MEDI-CAL ASSOCIATION JOURNAL 48.8 (2005): 422.
• 5.Sharma, S.B., Sharma, S.C. & Gupta, V. Spontaneous biliary perforation: a rare entity in late infancy and childhood. Indian J Pedi-atr 70,829–831(2003). https://doi.org/10.1007/BF02723808
• 6.Mohamad Halabi,Neil Merritt,Dhandapani Ashok, Emergency case of spontaneous com-mon bile duct (CBD) perforation. Canadian Liver Journal, Volume 1 Issue 4, Fall 2018, pp. 256-260
• 7.McLindon, J., England, R. & Martin, D. Causes, clinical features and non-operative management of bile leaks. Eur Radiol 8, 1602–1607(1998). https://doi.org/10.1007/s003300050595
• 8.Alwabari, Abdullah; Abbas, Gammal Spon-taneous bile duct perforation in an infant, managed with simple drainage, Annals of Pediatric Surgery: April 2015 - Volume 11 - Issue 2 - p 153-155 doi: 10.1097/01.XPS.0000462926.99853.97 9.C. Jeanty, S.C. Derderian, S. Hirose, H. Lee, B.E.-Padilla Spontaneous biliary perfora-tion in infancy: management strategies and outcomes-J Pediatr Surg, 50 (2015), pp. 1137-1141- https://www.sciencedirect.com/science/article/pii/S0022346814004758
• 10.Meseeha M, Attia M. Endoscopic Retro-grade Cholangiopancreatography. [Updated 2020 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.Availablefrom: https://www.ncbi.nlm.nih.gov/books/NBK493160/