Hybrid interventional radiological and surgical approach to treat biliary obstruction post Kasai portoenterostomy: A case report

IF 0.2 Q4 PEDIATRICS
Anand Dhatt , Ravjot Dhatt , Erik D. Skarsgard , Manraj K.S. Heran
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引用次数: 0

Abstract

Introduction

Kasai procedure is used in the management of biliary atresia. Complications can include stricturing at anastomoses which can result in impeded bile flow and subsequently ascending cholangitis that requires management.

Case report

We present a case of a 4-year old with multiple episodes of ascending cholangitis in the context of prior Kasai portoenterostomy at day 56 of life for non-syndromic biliary atresia. After prolonged hospital admission, imaging in the form of US and MR-cholangiopancreatography showed an obliterated portoenterostomy. A combined surgical and Interventional Radiology approach was utilized in the form of the surgical creation of a loop jejunostomy within the Roux limb and then traversing of the portoenterostomy under fluoroscopy to dilate the stricture and place an internal-external biliary drain. Subsequently, the patient's hyperbilirubinemia resolved with no further episodes of ascending cholangitis in 3 years of follow-up.

Conclusion

A hybrid, percutaneous and surgical approach is a feasible option to restore bile flow in patients post-Kasai who develop delayed cholestasis due to obliteration of the portoenterostomy.
开赛门静脉肠造口术后胆道梗阻的介入治疗:1例报告
介绍kasai手术治疗胆道闭锁。并发症包括吻合口狭窄,可导致胆汁流动受阻,随后需要治疗的上升胆管炎。病例报告:我们报告了一例4岁儿童,在非综合征性胆道闭锁的第56天,在Kasai门肠造口术的背景下,多次发作上升胆管炎。住院时间延长后,超声和磁共振胆管造影显示门肠造口闭塞。采用外科和介入放射学相结合的方法,在Roux肢体内手术建立环形空肠造口,然后在透视下穿过门肠造口,扩大狭窄并放置内外胆道引流管。随后,患者的高胆红素血症得到解决,在3年的随访中没有再发生上升性胆管炎。结论经皮和手术混合入路是恢复kasai术后因门肠造口闭塞而发生迟发性胆汁淤积的患者胆汁流动的可行选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
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