Saeed Anjum, El Mouzan Mohammed, Assiri Asaad, Alsarkhy Ahmed, Majeed Kashif
Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Khalid University Hospital, King Saud University, Riyadh, KSA.
Department of Pediatrics, King Khalid University Hospital, King Saud University, Riyadh, KSA.
J Coll Physicians Surg Pak. 2014 Nov;24 Suppl 3:S250-2.
Biliary ascites in children due to perforation of bile duct is a rare entity. The exact pathogenesis is not known but there are proposed mechanisms including congenital weakness of ductal wall, pancreaticobiliary malunion, tuberculosis, necrotizing enterocolitis and rupture of choledochal cyst. Presentation may be acute or sub-acute. Progressive insidious course is the common presentation in children with jaundice, clay colored stool, abdominal distension with slightly elevated liver enzymes but well documented cholestasis. Clinical suspicion with ultrasound, CT, MRCP and ascitic tap provides clue to the diagnosis. Both conservative and surgical interventions are in practice for managing these children. We report a 7 months old infant with biliary ascites due to perforation of bile duct.
儿童因胆管穿孔导致的胆汁性腹水是一种罕见病症。确切的发病机制尚不清楚，但有一些提出的机制，包括胆管壁先天性薄弱、胰胆管合流异常、结核病、坏死性小肠结肠炎以及胆总管囊肿破裂。其表现可能为急性或亚急性。渐进性隐匿病程是患有黄疸、陶土色大便、腹胀且肝酶轻度升高但胆汁淤积记录良好的儿童的常见表现。通过超声、CT、磁共振胰胆管造影（MRCP）和腹水穿刺进行临床怀疑可为诊断提供线索。在治疗这些儿童时，保守和手术干预措施都在实际应用中。我们报告了一名7个月大因胆管穿孔导致胆汁性腹水的婴儿。
