Sai Prasad T R, Chui Chan Hon, Low Yee, Chong Chia Li, Jacobsen Anette Sundfor
Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore.
Ann Acad Med Singap. 2006 Dec;35(12):905-8.
Bile duct perforation (BDP) with resultant biliary ascites in children is a rare clinical condition. The aetiopathogenesis is still an enigma, with increasing evidence suggesting anomalous union of pancreaticobiliary ductal (AUPBD) system as the prime causative factor.
We report 2 cases of spontaneous perforation of the bile duct confirmed on histopathological examination as choledochal cyst, in a 6-month-old female child and a 4-year-old boy who presented with subtle clinical symptoms.
Both patients were successfully managed by excision of the gall bladder and common bile duct and Roux-en- Y hepaticojejunostomy. This procedure was performed following initial cholecystostomy drainage in the second case.
From the available literature and experience with our patients, BDP is not merely spontaneous but may be related to AUPBD and choledochal cyst.
