Alissa K, Saunier P, Russo M, Vedrenne J
Service de pédiatrie, centre hospitalier, Fontainebleau, France.
Arch Pediatr. 1996 Feb;3(2):144-6. doi: 10.1016/0929-693x(96)85066-4.
Cholestasis associated with gallbladder lithiasis is quite uncommon in the neonate. We report such a case possibly due to a bacterial infection.
A 25 day-old neonate was admitted because he suffered from cholestatic jaundice associated with biological findings of inflammation. Hepatic cellular function and transaminases were normal. Ultrasonography showed hepatomegaly and a 10 mm diameter gallstone with sludge into the gallbladder. The patient was given cefotaxime plus netilmicine. Soluble antigenes for E coli were positive in the urine. Jaundice and inflammatory findings returned to normal within 10 days and ultrasonography was normal at the age of 20 months.
Neonatal E coli infection could be responsible for gallstone formation since E coli endotoxin may induce biliary stasis and favours lithogenous action of bacterial glycoproteins.
新生儿中与胆囊结石相关的胆汁淤积相当罕见。我们报告了这样一例可能由细菌感染引起的病例。
一名25日龄的新生儿因患有胆汁淤积性黄疸并伴有炎症的生物学表现而入院。肝细胞功能和转氨酶正常。超声检查显示肝脏肿大,胆囊内有一枚直径10毫米的胆结石及胆泥。给予患儿头孢噻肟加奈替米星治疗。尿液中大肠杆菌可溶性抗原呈阳性。黄疸和炎症表现于10天内恢复正常,20个月大时超声检查正常。
新生儿大肠杆菌感染可能是胆结石形成的原因,因为大肠杆菌内毒素可能导致胆汁淤积,并有利于细菌糖蛋白的致石作用。