title: Spontaneous biliary perforation in infancy and childhood: clues to diagnosis.
abstract: Spontaneous perforation of extrahepatic bile duct is rare. The cause is idiopathic once trauma and choledochal cyst are ruled out. The condition presents a diagnostic dilemma. Preoperative recognition is necessary as early surgical intervention gives excellent prognosis. We report clinical observations made in three cases with acute presentations. Diagnosis is to be suspected by the presence of jaundice after an initial anicteric period of good health with biliary ascites. This is confirmed by bilious abdominal paracentesis, signs of peritonitis and absent free gas on X ray. The constellation of these three findings was constant in three patients. The presented paper highlights the same as reliable clues to diagnosis.
authors.affiliation: Department of Pediatric Surgery, King George Medical and University (KGMU), Lucknow (UP), India. drravikanojia@yahoo.com
authors.forename: Ravi P
authors.initials: RP
authors.lastname: Kanojia
authors.forename: Shandip K
authors.initials: SK
authors.lastname: Sinha
authors.forename: Jiledar
authors.initials: J
authors.lastname: Rawat
authors.forename: Ashish
authors.initials: A
authors.lastname: Wakhlu
authors.forename: Shivnarain
authors.initials: S
authors.lastname: Kureel
authors.forename: Rajkumar
authors.initials: R
authors.lastname: Tandon
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000601:surgery; D017734:Bile Ducts, Extrahepatic; D002758:Cholangiography; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous