Ford W D, Sen S, Morris L, LeQuesne G
Department of Surgery, Adelaide Children's Hospital, South Australia.
Aust Paediatr J. 1988 Oct;24(5):306-8. doi: 10.1111/j.1440-1754.1988.tb01370.x.
The presence of bile in the peritoneal cavity and obstructive jaundice without liver derangement in the neonatal period is pathognomonic of spontaneous perforation of the bile-ducts. These features can be demonstrated preoperatively with ultrasound, nuclide imaging and liver function tests, without recourse to paracentesis, and the risk of contaminating the bile ascites. Furthermore, the presence of isotope in the general peritoneal cavity will exclude the diagnosis of a choledochal cyst so that jejunum should not be anastamosed to the 'false capsule' of a spontaneous perforation.
新生儿期腹腔内胆汁的存在以及无肝脏功能紊乱的梗阻性黄疸是胆管自发性穿孔的特征性表现。这些特征可通过超声、核素成像和肝功能检查在术前得以证实，而无需进行腹腔穿刺，从而避免胆汁性腹水受到污染。此外，全腹腔内存在同位素可排除胆总管囊肿的诊断，因此空肠不应与自发性穿孔的“假囊”进行吻合。
