Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1991 Dec;66(12):1395–1398. doi: 10.1136/adc.66.12.1395

Intraluminal biliary obstruction.

N D Heaton 1, M Davenport 1, E R Howard 1
PMCID: PMC1793378  PMID: 1776884

Abstract

Jaundice caused by intraluminal bile duct obstruction in infancy is rare but may occur in association with biliary sludge, inspissated bile plugs, or gall stones. Nine boys (aged 2 weeks-6 months) with obstruction caused by inspissated bile (n = 7) or gall stones (n = 2) are presented. Haemolysis was not a factor in the patients' histories but an abnormal entry of the common bile duct into the third part of the duodenum was demonstrated in two and one had an asymptomatic haemangioma. Ultrasonography was the most useful investigation. Surgical removal of the bile duct obstruction was necessary in eight cases and included biliary tract drainage in six and cholecystectomy for changes of cholecystitis in four. Obstruction resolved spontaneously in one infant after percutaneous cholangiography. There were no postoperative complications.

Full text

PDF
1395

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Avni E. F., Matos C., Van Gansbeke D., Muller F. Atypical gallbladder content in newborn infants: ultrasonic demonstration. Ann Radiol (Paris) 1986;29(3-4):267–273. [PubMed] [Google Scholar]
  2. Balistreri W. F. Neonatal cholestasis. J Pediatr. 1985 Feb;106(2):171–184. doi: 10.1016/s0022-3476(85)80282-1. [DOI] [PubMed] [Google Scholar]
  3. Benjamin D. R. Cholelithiasis in infants: the role of total parenteral nutrition and gastrointestinal dysfunction. J Pediatr Surg. 1982 Aug;17(4):386–389. doi: 10.1016/s0022-3468(82)80495-8. [DOI] [PubMed] [Google Scholar]
  4. Bowen A. Ultrasound of the normal neonatal gallbladder. Diagn Imaging Clin Med. 1984;53(5):231–236. [PubMed] [Google Scholar]
  5. Brown D. M. Bile plug syndrome: successful management with a mucolytic agent. J Pediatr Surg. 1990 Mar;25(3):351–352. doi: 10.1016/0022-3468(90)90086-o. [DOI] [PubMed] [Google Scholar]
  6. Davies C., Daneman A., Stringer D. A. Inspissated bile in a neonate with cystic fibrosis. J Ultrasound Med. 1986 Jun;5(6):335–337. doi: 10.7863/jum.1986.5.6.335. [DOI] [PubMed] [Google Scholar]
  7. Enzenauer R. W., Montrey J. S., Barcia P. J., Woods J. Total parenteral nutrition cholestasis: a cause of mechanical biliary obstruction. Pediatrics. 1985 Dec;76(6):905–908. [PubMed] [Google Scholar]
  8. Gur I., Vinograd I., Dgani Y., Arad I. Obstructive jaundice due to inspissated bile following disseminated intravascular coagulation. Isr J Med Sci. 1986 Jun;22(6):448–450. [PubMed] [Google Scholar]
  9. HSIA D. Y. Y., PATTERSON P., ALLEN F. H., Jr, DIAMOND L. K., GELLIS S. S. Prolonged obstructive jaundice in infancy. I. General survey of 156 cases. Pediatrics. 1952 Sep;10(3):243–252. [PubMed] [Google Scholar]
  10. Holgersen L. O., Stolar C., Berdon W. E., Hilfer C., Levy J. S. Therapeutic and diagnostic implications of acquired choledochal obstruction in infancy: spontaneous resolution in three infants. J Pediatr Surg. 1990 Oct;25(10):1027–1029. doi: 10.1016/0022-3468(90)90211-q. [DOI] [PubMed] [Google Scholar]
  11. Jacir N. N., Anderson K. D., Eichelberger M., Guzzetta P. C. Cholelithiasis in infancy: resolution of gallstones in three of four infants. J Pediatr Surg. 1986 Jul;21(7):567–569. doi: 10.1016/s0022-3468(86)80405-5. [DOI] [PubMed] [Google Scholar]
  12. Kochhar R., Nagi B., Chawla S., Das K., Rao K. L., Mitra S. K., Mehta S. K. The clinical spectrum of anomalous pancreatobiliary junction. Surg Endosc. 1989;3(2):83–86. doi: 10.1007/BF00590906. [DOI] [PubMed] [Google Scholar]
  13. Ladd W. E. CONGENITAL OBSTRUCTION OF THE BILE DUCTS. Ann Surg. 1935 Oct;102(4):742–751. doi: 10.1097/00000658-193510000-00021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lilly J. R. Common bile duct calculi in infants and children. J Pediatr Surg. 1980 Aug;15(4):577–580. doi: 10.1016/s0022-3468(80)80777-9. [DOI] [PubMed] [Google Scholar]
  15. Lilly J. R., Sokol R. J. On the bile sludge syndrome or is total parenteral nutrition cholestasis a surgical disease? Pediatrics. 1985 Dec;76(6):992–993. [PubMed] [Google Scholar]
  16. MacMillan R. W., Schullinger J. N., Santulli T. V. Cholelithiasis in childhood. Am J Surg. 1974 Jun;127(6):689–692. doi: 10.1016/0002-9610(74)90348-1. [DOI] [PubMed] [Google Scholar]
  17. Moossa A. R. Cholelithiasis in childhood. J R Coll Surg Edinb. 1973 Jan;18(1):42–46. [PubMed] [Google Scholar]
  18. Morales L., Taboada E., Toledo L., Radrigan W. Cholecystitis and cholelithiasis in children. J Pediatr Surg. 1967 Dec;2(6):565–568. doi: 10.1016/s0022-3468(67)80014-9. [DOI] [PubMed] [Google Scholar]
  19. OPPE T. E., VALAES T. Obstructive jaundice and haemolytic disease of the newborn. Lancet. 1959 Mar 14;1(7072):536–539. doi: 10.1016/s0140-6736(59)92307-4. [DOI] [PubMed] [Google Scholar]
  20. Pellerin D., Bertin P., Nihoul-Fekete C., Ricour C. Cholelithiasis and ileal pathology in childhood. J Pediatr Surg. 1975 Feb;10(1):35–41. doi: 10.1016/s0022-3468(75)80006-6. [DOI] [PubMed] [Google Scholar]
  21. Rodgers B. M., Hollenbeck J. I., Donnelly W. H., Talbert J. L. Intrahepatic cholestasis with parental alimentation. Am J Surg. 1976 Feb;131(2):149–155. doi: 10.1016/0002-9610(76)90088-x. [DOI] [PubMed] [Google Scholar]
  22. Roslyn J. J., Berquist W. E., Pitt H. A., Mann L. L., Kangarloo H., DenBesten L., Ament M. E. Increased risk of gallstones in children receiving total parenteral nutrition. Pediatrics. 1983 May;71(5):784–789. [PubMed] [Google Scholar]
  23. Schirmer W. J., Grisoni E. R., Gauderer M. W. The spectrum of cholelithiasis in the first year of life. J Pediatr Surg. 1989 Oct;24(10):1064–1067. doi: 10.1016/s0022-3468(89)80216-7. [DOI] [PubMed] [Google Scholar]
  24. Spivak W., Sarkar S., Winter D., Glassman M., Donlon E., Tucker K. J. Diagnostic utility of hepatobiliary scintigraphy with 99mTc-DISIDA in neonatal cholestasis. J Pediatr. 1987 Jun;110(6):855–861. doi: 10.1016/s0022-3476(87)80396-7. [DOI] [PubMed] [Google Scholar]
  25. Touloukian R. J., Seashore J. H. Hepatic secretory obstruction with total parenteral nutrition in the infant. J Pediatr Surg. 1975 Jun;10(3):353–360. doi: 10.1016/0022-3468(75)90098-6. [DOI] [PubMed] [Google Scholar]
  26. Whitington P. F., Black D. D. Cholelithiasis in premature infants treated with parenteral nutrition and furosemide. J Pediatr. 1980 Oct;97(4):647–649. doi: 10.1016/s0022-3476(80)80033-3. [DOI] [PubMed] [Google Scholar]
  27. Wilkinson M. L., Mieli-Vergani G., Ball C., Portmann B., Mowat A. P. Endoscopic retrograde cholangiopancreatography in infantile cholestasis. Arch Dis Child. 1991 Jan;66(1):121–123. doi: 10.1136/adc.66.1.121. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES