Neonatal spontaneous biliary perforation: Case report

Abstract

Objective

Spontaneous biliary perforation in neonates is rare. The etiology of this pathology is idiopathic and various management strategies ranging from non-operative treatment to complex operations, such as biliary-enteric reconstruction, are performed, with few reported outcomes.

Case report

A 3-week-old female, born at term, presented fever, abdominal distension, and acholic stool. An ultrasound was performed, which revealed generalized ascites and a poorly-defined collection. An emergency laparotomy confirmed perforation in the distal common bile duct and a biliary-enteric-anastomosis was performed.

Discussion

Wide drainage has been reported as the best initial management strategy for spontaneous biliary perforation, although it depends on the patient's clinical status and intraoperative findings.

Conclusions

Spontaneous infantile biliary perforation is rare. Main management is wide drainage with, most perforations being resolved in 2 weeks.