MR cholangiopancreatography findings in children with spontaneous bile duct perforation.
BACKGROUND
Spontaneous bile duct perforation (SBP) is rare in children. Early diagnosis is important because the condition can be treated surgically.


OBJECTIVE
The purpose of this study is to report MR cholangiopancreatography (MRCP) findings of SBP and to evaluate the usefulness of MRCP.


METHODS
Over the last 10 years, three children (1 boy, 2 girls; ages 3, 4 and 15 months) underwent US, MRCP and hepatobiliary scintigraphy preoperatively and were surgically confirmed to have extrahepatic bile duct perforation.


RESULTS
US showed ascites in all children and a choledochal cyst in one. On MRCP, a moderate-to-large volume of ascites was seen in addition to a loculated fluid collection at the porta hepatis. MRCP also depicted the low insertion of the cystic duct and choledochal cyst in each case. Hepatobiliary scintigraphy showed bile leak from the region of the porta hepatis extending to the whole abdomen. According to the surgical findings, the perforation site was around the junction of the cystic duct and the common hepatic duct in all children.


CONCLUSIONS
In children with SBP, MRCP can depict the loculated fluid collection adjacent to the perforation site and associated bile duct anomalies.
Lee
Mi-Jung
MJ
Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University, College of Medicine, 250 Seongsanno (134 Sinchon-dong), Seodaemungu, Seoul, 120-752, Korea.
Kim
Myung-Joon
MJ
Yoon
Choon-Sik
CS
D001646:Bile / Q000166:cytology*; D001652:Bile Ducts / Q000293:injuries* / Q000473:pathology*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014950:Wounds, Penetrating / Q000473:pathology*