title: Management of biliary perforation in children.
abstract: BACKGROUND
  To study the aetiology, management and outcome of biliary perforations in paediatric age group.
  
  
  METHODS
  In a retrospective study, the records of patients presented with biliary peritonitis due to biliary perforations, managed from March 2006 to July 2009, are reviewed.
  
  
  RESULTS
  Eight male patients with biliary peritonitis due to biliary perforation were managed. These patients were divided in two groups, A and B. Group A, (n = 3) patients, had common bile duct (CBD) perforation, and Group B (n=5) patients had gallbladder perforation. The presenting features were abdominal pain, fever, abdominal distension, vomiting, constipation, jaundice and signs of peritonism. The management of CBD perforations in Group A was by draining the site of perforation and biliary diversion (tube cholecystostomy). In Group B, the gallbladder perforations were managed by tube cholecystostomy in four patients and cholecystectomy in one patient, however, one patient had to be re-explored and cholecystectomy performed due to complete necrosis of gall bladder. There was no mortality in our series. All patients were asymptomatic on regular follow-up.
  
  
  CONCLUSIONS
  Early optimal management of biliary perforations remarkably improved the very high mortality and morbidity that characterised this condition in the past.
authors.affiliation: Department of Paediatric Surgery, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan. blmirza@yahoo.com
authors.forename: Bilal
authors.initials: B
authors.lastname: Mirza
authors.forename: Lubna
authors.initials: L
authors.lastname: Ijaz
authors.forename: Muhammad
authors.initials: M
authors.lastname: Saleem
authors.forename: Shahid
authors.initials: S
authors.lastname: Iqbal
authors.forename: Muhammad
authors.initials: M
authors.lastname: Sharif
authors.forename: Afzal
authors.initials: A
authors.lastname: Sheikh
mesh_terms: D001649:Bile Duct Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D002767:Cholecystostomy; D003135:Common Bile Duct / Q000293:injuries*; D005704:Gallbladder / Q000293:injuries*; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D010538:Peritonitis / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome