Bile Peritonitis Due to Spontaneous Rupture of Choledochal Cyst iagnosed by Hepatobiliary Scintigraphy in an Infant.
- Author:
Jong Seok KIM
1
;
Jang Hun LIM
;
Sang Nam BAE
;
Jun Woo LEE
;
In Ju KIM
;
Jae Hong PARK
Author Information
1. Department of Pediatrics, Dae Dong Hospital, Korea.
- Publication Type:Case Report
- Keywords:
Bile peritonitis;
Choledochal cyst;
Hepatobiliary scintigraphy
- MeSH:
Abdominal Pain;
Ascites;
Ascitic Fluid;
Bile*;
Biliary Tract;
Bilirubin;
Choledochal Cyst*;
Diagnosis;
Diarrhea;
Female;
Fever;
Humans;
Infant*;
Jaundice;
Pancreatic Juice;
Peritonitis*;
Radionuclide Imaging*;
Rupture;
Rupture, Spontaneous*;
Technetium Tc 99m Disofenin
- From:Korean Journal of Pediatric Gastroenterology and Nutrition
2002;5(2):186-191
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Choledochal cyst is a congenital anomaly with classic triad of abdominal pain, jaundice and right upper abdominal mass. Bile peritonitis caused by cyst rupture is relatively not rare in infancy. The mechanism of rupture must be epithelial irritation of the biliary tract by refluxed pancreatic juice caused by pancreatico-biliary malunion associated with mural immaturity in infancy, rather than an abnormal rise in ductal pressure or congenital mural weakness at a certain point. We experienced a case of bile peritonitis caused by spontanenous rupture of choledochal cyst in a 10-month-old girl presented with abdominal distension, persistent fever, diarrhea, irritability and intractable ascites. She was presumed as having bile peritonitis by bile colored ascitic fluid with elevated bilirubin level and diagnosis was made by 99mTc DISIDA hepatobiliary scan showing extrahepatic biliary leak. The perforated cyst was surgically removed and the biliary tree was reconstructed with a Roux-en-Y hepaticojejunostomy.
