[Spontaneous perforation of the bile duct in a neonate: An unexpected finding. Case report].
| Autor: | Beltrán Joan M; Cuidado Intensivo Pediatrico, Universidad de Santander, Bucaramanga, Santander, Colombia., Niño Tovar MA; Unidad Neonatal, Departamento de Pediatría, Fundación Cardiovascular de Colombia, Floridablanca, Santander, Colombia., León Martínez J; Departamento de Radiología, Fundación Cardiovascular de Colombia, Colombia., Cruz Hernández M; Unidad Neonatal, Departamento de Pediatría, Fundación Cardiovascular de Colombia, Floridablanca, Santander, Colombia., Alvarado Socarras JL; Organización Latinoamericana para el fomento de la Investigación en Salud, Unidad Neonatal, Departamento de Pediatría, Fundación Cardiovascular de Colombia, Colombia. |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Revista chilena de pediatria [Rev Chil Pediatr] 2017; Vol. 88 (5), pp. 656-661. |
| DOI: | 10.4067/S0370-41062017000500014 |
| Abstrakt: | Spontaneous extrahepatic bile duct perforation is rare in newborns. It is a surgical cause of jaundice in this period and the acute presentation is unusual. Objective: To report a case of spontaneous bile duct perforation in a newborn due to its serious complications if an early and timely diagnosis is not performed. Clinical Case: A 10-day-old newborn who developed food rejection, fever and abdominal distension without jaundice, acolia, or coluria two days prior of admission. The laboratory tests showed leukopenia, thrombocytosis, increased C-reactive protein, and normal hepatic function. The abdominal x-ray showed pneumoperitoneum, and the diagnosis of necrotizing enterocolitis was made. Laparotomy was performed; extrahepatic bile duct perforation and biliary peritonitis were noted. Intraoperative cholangiography demonstrated rescatable proximal bile duct and dilated cystic duct. Hepatic-jejunostomy was performed with Roux-en-Y and cholecystectomy. In the postoperative study portal thrombosis was found, so he received anticoagulant treatment. At 8 months of age, the patient had enteral feeding tolerance and adequate weight gain. Conclusions: Biliary perforation is a rare entity and more in the neonatal period, a condition that makes it a diagnostic and therapeutic challenge. The prognosis will depend on early intervention and intraoperative findings. |
| Databáze: | MEDLINE |
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