title: Spontaneous perforation of the extrahepatic bile duct in infancy: report of two cases and literature review.
abstract: BACKGROUND
  Spontaneous perforation of the bile duct (SPBD) is a rare disease in infancy. The pathogenesis, diagnostic modalities and treatment options for this condition are reviewed and discussed.
  
  
  METHODS
  The authors report 2 new observations of SPBD in 2 male newborns aged respectively 27 and 21 days.
  
  
  RESULTS
  The 2 newborns presented with cholestatic jaundice. Abdominal sonography showed an extrahepatic mass. Exploratory laparotomy revealed that the perforation was located in the cystic duct in the first case and in the common bile duct (CBD) in the second. The site of perforation was repaired and both patients underwent simple external biliary drainage. The postoperative course was uneventful for both patients with follow-up ranging from 2 to 4 years.
  
  
  CONCLUSIONS
  SPBD is a rare, but important cause of surgical jaundice in infants. The pathogenesis of SPBD is unknown and multifactorial and diagnosis is often problematic. Surgical management is always required and a conservative approach is usually recommended. The prognosis is good with early surgical management.
authors.affiliation: Department of Paediatric Surgery, Hospital Fattouma, Bourguiba, Monastir, Tunisia. lassaad.sahnoun@rns.tn
authors.forename: L
authors.initials: L
authors.lastname: Sahnoun
authors.forename: M
authors.initials: M
authors.lastname: Belghith
authors.forename: R
authors.initials: R
authors.lastname: Jouini
authors.forename: M
authors.initials: M
authors.lastname: Jallouli
authors.forename: K
authors.initials: K
authors.lastname: Maazoun
authors.forename: I
authors.initials: I
authors.lastname: Krichene
authors.forename: M
authors.initials: M
authors.lastname: Mekki
authors.forename: M
authors.initials: M
authors.lastname: Ben Brahim
authors.forename: A
authors.initials: A
authors.lastname: Nouri
mesh_terms: D001649:Bile Duct Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging; D002758:Cholangiography; D006801:Humans; D007231:Infant, Newborn; D041781:Jaundice, Obstructive / Q000209:etiology; D008297:Male; D012422:Rupture, Spontaneous