PDF(Pubmed)
Abstract：
Biliary ascites due to spontaneous biliary duct perforation is a rare case presentation usually seen in the paediatric age group of 6-36 months. We are presenting the case of a 14-month-old baby with abdominal distention associated with abdominal pain, vomiting, fever, and a history of no passage of stools. Upon examination, the abdomen was tense and tender. On radiological investigations, gross free fluid was present in the abdominal cavity along with bowel obstruction and partial situs inversus of the spleen and stomach. The bowel obstruction was relieved by rectal stimulation, after which oral feeds were well tolerated. Bilious fluid was found on diagnostic paracentesis, confirming the diagnosis. The patient was managed further by broad-spectrum antibiotics and drainage of the free fluid. The management ranges from conservative treatment to Roux-en-Y anastomosis. A non-surgical diagnosis is uncommonly seen and helps improve the patient\'s prognosis if detected early. This case report highlights the importance of early diagnosis and non-surgical treatment modality in critical patients.
摘要：
自发性胆管穿孔引起的胆汁性腹水是一种罕见的病例，通常在6-36个月的儿科年龄组中看到。我们正在介绍一个14个月大的婴儿腹胀伴腹痛的病例，呕吐,发烧,和没有大便的历史。经检查,腹部紧张而柔软。关于放射学调查，腹腔中存在大量游离液，并伴有肠梗阻和脾胃部分倒置。经直肠刺激后肠梗阻缓解,之后口服喂养耐受性良好。诊断性穿刺发现胆汁液，确认诊断。患者进一步接受广谱抗生素和游离液体引流治疗。治疗范围从保守治疗到Roux-en-Y吻合术。非手术诊断是罕见的，如果早期发现，有助于改善患者的预后。此病例报告强调了危重患者早期诊断和非手术治疗方式的重要性。
