Spontaneous biliary perforation in childhood: an unexpected finding – Case report
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Research, Society and Development |
Texto Completo: | https://rsdjournal.org/index.php/rsd/article/view/33376 |
Resumo: | Spontaneous extrahepatic bile duct perforation is a rare cause of cholestasis in childhood in which the diagnosis is often only determined through exploratory laparotomy and the acute clinical presentation is uncommon. The prognosis is good when diagnosed early. Objective: to report the case of spontaneous bile duct perforation in an infant and its possible complications after surgical treatment. Case report: A 2-month-old infant who developed progressive weight loss associated with fecal acolia, intermittent choluria and abdominal distension for 1 month. Laboratory tests showed increased transaminases with normal liver function. Abdominal USG showed voluminous ascites, performed paracentesis with drainage of bilious fluid. Percutaneous cholangiography showed possible perforation at the level of the common bile duct, laparotomy was performed; Extrahepatic bile duct perforation was found, cholecystectomy and simple bile duct raffia were performed. In the postoperative study, at 8 months, the patient developed upper digestive hemorrhage secondary to esophageal varices due to portal vein thrombosis; needed treatment with vasopressin in the acute setting and follow-up with serial sclerotherapy associated with the established clinical treatment. Comments: Biliary perforation is a rare condition that makes it a diagnostic and therapeutic challenge. The prognosis will depend on early intervention and intraoperative findings. |
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Spontaneous biliary perforation in childhood: an unexpected finding – Case reportPerforación biliar espontánea en la infancia: hallazgo inesperado – Reporte de casoPerfuração biliar espontânea na infância: um achado inesperado – Relato de casoPerforación espontáneaConducto biliarColestasis extrahepáticaTrombosis venosaVárices esofágicas y gástricas.Perfuração espontâneaVia biliarColestase extra-hepáticaTrombose venosaVarizes esofágicas e gástricas.Spontaneous perforationBile ductsCholestasis extrahepaticVenous thrombosisEsophageal and gastric varices.Spontaneous extrahepatic bile duct perforation is a rare cause of cholestasis in childhood in which the diagnosis is often only determined through exploratory laparotomy and the acute clinical presentation is uncommon. The prognosis is good when diagnosed early. Objective: to report the case of spontaneous bile duct perforation in an infant and its possible complications after surgical treatment. Case report: A 2-month-old infant who developed progressive weight loss associated with fecal acolia, intermittent choluria and abdominal distension for 1 month. Laboratory tests showed increased transaminases with normal liver function. Abdominal USG showed voluminous ascites, performed paracentesis with drainage of bilious fluid. Percutaneous cholangiography showed possible perforation at the level of the common bile duct, laparotomy was performed; Extrahepatic bile duct perforation was found, cholecystectomy and simple bile duct raffia were performed. In the postoperative study, at 8 months, the patient developed upper digestive hemorrhage secondary to esophageal varices due to portal vein thrombosis; needed treatment with vasopressin in the acute setting and follow-up with serial sclerotherapy associated with the established clinical treatment. Comments: Biliary perforation is a rare condition that makes it a diagnostic and therapeutic challenge. The prognosis will depend on early intervention and intraoperative findings.La perforación espontánea de la vía biliar extrahepática es una causa rara de colestasis infantil en la que el diagnóstico muchas veces solo se determina mediante laparotomía exploradora y la presentación clínica aguda es infrecuente. El pronóstico es bueno cuando se diagnostica a tiempo. Objetivo: reportar el caso de perforación espontánea de la vía biliar en un lactante y sus posibles complicaciones luego del tratamiento quirúrgico. Caso clínico: Lactante de 2 meses de edad que desarrolló pérdida de peso progresiva asociada a acolia fecal, coluria intermitente y distensión abdominal de 1 mes de evolución. Los exámenes de laboratorio mostraron aumento de transaminasas con función hepática normal. USG abdominal mostró ascitis voluminosa, se realizó paracentesis con drenaje de líquido bilioso. La colangiografía percutánea mostró posible perforación a nivel del colédoco, se realizó laparotomía; se encontró perforación de vía biliar extrahepática, se realizó colecistectomía y sutura de colédoco simple. En el estudio posoperatorio, a los 8 meses, la paciente presentó hemorragia digestiva alta secundaria a várices esofágicas por trombosis de la vena porta; requirió tratamiento con vasopresina en el cuadro agudo y seguimiento con escleroterapia seriada asociada al tratamiento clínico establecido. Comentarios: La perforación biliar es una condición rara que la convierte en un desafío diagnóstico y terapéutico. El pronóstico dependerá de la intervención temprana y los hallazgos intraoperatorios.Perfuração espontânea de via biliar extra-hepática é uma causa rara de colestase na infância em que muitas vezes o diagnóstico só é determinado através da laparotomia exploradora e a apresentação clínica aguda é incomum. O prognóstico é bom quando diagnóstico precoce. Objetivo: reportar o caso de perfuração espontânea de via biliar em lactente e suas possíveis complicações após tratamento cirúrgico. Caso clínico: Lactente de 2 meses que evoluiu com quadro de perda ponderal progressiva associado à acolia fecal, colúria intermitente e distensão abdominal há 1 mês. Os exames laboratoriais mostraram aumento de transaminases com função hepática normal. USG abdominal evidenciou ascite volumosa, realizada paracentese com drenagem de líquido bilioso. Colangiografia percutânea evidenciou possível perfuração a nível de ducto biliar comum, laparotomia foi realizada; perfuração do ducto biliar extra-hepático foi encontrado, realizada colecistectomia e rafia simples do colédoco. No estudo pós-operatório, aos 8 meses, paciente evoluiu com hemorragia digestiva alta secundária a varizes esofagianas por trombose de veia porta; necessitou tratamento com vasopressina no quadro agudo e seguimento com escleroterapia seriada associado ao tratamento clínico instituído. Comentários: A perfuração biliar é uma entidade rara condição que a torna um desafio diagnóstico e terapêutico. O prognóstico dependerá da intervenção precoce e dos achados intraoperatórios.Research, Society and Development2022-08-21info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://rsdjournal.org/index.php/rsd/article/view/3337610.33448/rsd-v11i11.33376Research, Society and Development; Vol. 11 No. 11; e242111133376Research, Society and Development; Vol. 11 Núm. 11; e242111133376Research, Society and Development; v. 11 n. 11; e2421111333762525-3409reponame:Research, Society and Developmentinstname:Universidade Federal de Itajubá (UNIFEI)instacron:UNIFEIporhttps://rsdjournal.org/index.php/rsd/article/view/33376/28393Copyright (c) 2022 Anahy Albaneze Vianna; Alessandra Chaves Miranda; Leonardo Rodrigues Resendehttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessVianna, Anahy Albaneze Miranda, Alessandra Chaves Resende, Leonardo Rodrigues 2022-09-05T13:24:46Zoai:ojs.pkp.sfu.ca:article/33376Revistahttps://rsdjournal.org/index.php/rsd/indexPUBhttps://rsdjournal.org/index.php/rsd/oairsd.articles@gmail.com2525-34092525-3409opendoar:2024-01-17T09:49:02.977603Research, Society and Development - Universidade Federal de Itajubá (UNIFEI)false |
dc.title.none.fl_str_mv |
Spontaneous biliary perforation in childhood: an unexpected finding – Case report Perforación biliar espontánea en la infancia: hallazgo inesperado – Reporte de caso Perfuração biliar espontânea na infância: um achado inesperado – Relato de caso |
title |
Spontaneous biliary perforation in childhood: an unexpected finding – Case report |
spellingShingle |
Spontaneous biliary perforation in childhood: an unexpected finding – Case report Vianna, Anahy Albaneze Perforación espontánea Conducto biliar Colestasis extrahepática Trombosis venosa Várices esofágicas y gástricas. Perfuração espontânea Via biliar Colestase extra-hepática Trombose venosa Varizes esofágicas e gástricas. Spontaneous perforation Bile ducts Cholestasis extrahepatic Venous thrombosis Esophageal and gastric varices. |
title_short |
Spontaneous biliary perforation in childhood: an unexpected finding – Case report |
title_full |
Spontaneous biliary perforation in childhood: an unexpected finding – Case report |
title_fullStr |
Spontaneous biliary perforation in childhood: an unexpected finding – Case report |
title_full_unstemmed |
Spontaneous biliary perforation in childhood: an unexpected finding – Case report |
title_sort |
Spontaneous biliary perforation in childhood: an unexpected finding – Case report |
author |
Vianna, Anahy Albaneze |
author_facet |
Vianna, Anahy Albaneze Miranda, Alessandra Chaves Resende, Leonardo Rodrigues |
author_role |
author |
author2 |
Miranda, Alessandra Chaves Resende, Leonardo Rodrigues |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Vianna, Anahy Albaneze Miranda, Alessandra Chaves Resende, Leonardo Rodrigues |
dc.subject.por.fl_str_mv |
Perforación espontánea Conducto biliar Colestasis extrahepática Trombosis venosa Várices esofágicas y gástricas. Perfuração espontânea Via biliar Colestase extra-hepática Trombose venosa Varizes esofágicas e gástricas. Spontaneous perforation Bile ducts Cholestasis extrahepatic Venous thrombosis Esophageal and gastric varices. |
topic |
Perforación espontánea Conducto biliar Colestasis extrahepática Trombosis venosa Várices esofágicas y gástricas. Perfuração espontânea Via biliar Colestase extra-hepática Trombose venosa Varizes esofágicas e gástricas. Spontaneous perforation Bile ducts Cholestasis extrahepatic Venous thrombosis Esophageal and gastric varices. |
description |
Spontaneous extrahepatic bile duct perforation is a rare cause of cholestasis in childhood in which the diagnosis is often only determined through exploratory laparotomy and the acute clinical presentation is uncommon. The prognosis is good when diagnosed early. Objective: to report the case of spontaneous bile duct perforation in an infant and its possible complications after surgical treatment. Case report: A 2-month-old infant who developed progressive weight loss associated with fecal acolia, intermittent choluria and abdominal distension for 1 month. Laboratory tests showed increased transaminases with normal liver function. Abdominal USG showed voluminous ascites, performed paracentesis with drainage of bilious fluid. Percutaneous cholangiography showed possible perforation at the level of the common bile duct, laparotomy was performed; Extrahepatic bile duct perforation was found, cholecystectomy and simple bile duct raffia were performed. In the postoperative study, at 8 months, the patient developed upper digestive hemorrhage secondary to esophageal varices due to portal vein thrombosis; needed treatment with vasopressin in the acute setting and follow-up with serial sclerotherapy associated with the established clinical treatment. Comments: Biliary perforation is a rare condition that makes it a diagnostic and therapeutic challenge. The prognosis will depend on early intervention and intraoperative findings. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-08-21 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://rsdjournal.org/index.php/rsd/article/view/33376 10.33448/rsd-v11i11.33376 |
url |
https://rsdjournal.org/index.php/rsd/article/view/33376 |
identifier_str_mv |
10.33448/rsd-v11i11.33376 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://rsdjournal.org/index.php/rsd/article/view/33376/28393 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2022 Anahy Albaneze Vianna; Alessandra Chaves Miranda; Leonardo Rodrigues Resende https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2022 Anahy Albaneze Vianna; Alessandra Chaves Miranda; Leonardo Rodrigues Resende https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Research, Society and Development |
publisher.none.fl_str_mv |
Research, Society and Development |
dc.source.none.fl_str_mv |
Research, Society and Development; Vol. 11 No. 11; e242111133376 Research, Society and Development; Vol. 11 Núm. 11; e242111133376 Research, Society and Development; v. 11 n. 11; e242111133376 2525-3409 reponame:Research, Society and Development instname:Universidade Federal de Itajubá (UNIFEI) instacron:UNIFEI |
instname_str |
Universidade Federal de Itajubá (UNIFEI) |
instacron_str |
UNIFEI |
institution |
UNIFEI |
reponame_str |
Research, Society and Development |
collection |
Research, Society and Development |
repository.name.fl_str_mv |
Research, Society and Development - Universidade Federal de Itajubá (UNIFEI) |
repository.mail.fl_str_mv |
rsd.articles@gmail.com |
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1797052720738205696 |