Spontaneous Bile Duct Perforation: Two Case Reports and Literature Review.

Abstract

Spontaneous perforation of the biliary ducts is a rare disorder in infants. Early diagnosis of this entity is important because it can be treated surgically. The authors report on two patients with spontaneous biliary perforation who were treated during the year 2020 and 2022. The diagnosis was made in two children aged 2 and 4 months presenting progressive abdominal distension associated with jaundice, acholic stools and elevated bilirubin in the ascites fluid. Surgical exploration by laparotomy confirmed biliary duct perforation. Cholecystectomy were performed including a suture of the perforation in one patient and an external surgical drainage in the second. Perforation of the bile ducts should be suspected in every neonate and infant with ascites and jaundice. Confirmation is obtained by paracentesis and bilirubin measurement in the ascitic fluid or by combination of sonography and scintigraphy.

 Keywords: cholestasis, spontaneous perforation of biliary duct, biliary ascites, Surgery, Infancy