Ultrasound-guided percutaneous cholecystostomy for acute neonatal biliary obstruction. 2007

Radley Helin, and Rama Bhat, and Bhaskara Rao
Department of Pediatrics, University of Illinois Medical Center, Chicago, IL 60612, USA. rhelin1@uic.edu

Use of a percutaneously-inserted cholecystostomy drainage tube is an effective therapeutic option for acute hyperbilirubinemia in severely-ill adult patients, but to our knowledge has not been previously reported in infants. We describe an infant who developed acute extrahepatic biliary tract obstruction with marked conjugated (direct) hyperbilirubinemia, and who was determined to be an unsuitable surgical candidate. Ultrasound-guided percutaneous cholecystostomy was performed and resulted in prompt, significant, and sustained decline in serum bilirubin levels. Potential risks and benefits, as well as suggested indications for the procedure are discussed.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D002763 Cholecystectomy Surgical removal of the GALLBLADDER. Cholecystectomies
D006554 Hernia, Umbilical A HERNIA due to an imperfect closure or weakness of the umbilical ring. It appears as a skin-covered protrusion at the UMBILICUS during crying, coughing, or straining. The hernia generally consists of OMENTUM or SMALL INTESTINE. The vast majority of umbilical hernias are congenital but can be acquired due to severe abdominal distention. Exomphalos,Omphalocele,Umbilical Hernia,Hernias, Umbilical,Omphaloceles,Umbilical Hernias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001651 Cholestasis, Extrahepatic Impairment of bile flow in the large BILE DUCTS by mechanical obstruction or stricture due to benign or malignant processes. Bile Duct Obstruction, Extrahepatic,Biliary Stasis, Extrahepatic,Extrahepatic Cholestasis,Extrahepatic Biliary Stasis
D001663 Bilirubin A bile pigment that is a degradation product of HEME. Bilirubin IX alpha,Bilirubin, (15E)-Isomer,Bilirubin, (4E)-Isomer,Bilirubin, (4E,15E)-Isomer,Bilirubin, Calcium Salt,Bilirubin, Disodium Salt,Bilirubin, Monosodium Salt,Calcium Bilirubinate,Hematoidin,delta-Bilirubin,Bilirubinate, Calcium,Calcium Salt Bilirubin,Disodium Salt Bilirubin,Monosodium Salt Bilirubin,Salt Bilirubin, Calcium,delta Bilirubin
D016343 Monitoring, Intraoperative The constant checking on the state or condition of a patient during the course of a surgical operation (e.g., checking of vital signs). Intraoperative Monitoring
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D041781 Jaundice, Obstructive Jaundice, the condition with yellowish staining of the skin and mucous membranes, that is due to impaired BILE flow in the BILIARY TRACT, such as INTRAHEPATIC CHOLESTASIS, or EXTRAHEPATIC CHOLESTASIS. Jaundice, Cholestatic,Jaundice, Mechanical,Cholestatic Jaundice,Mechanical Jaundice,Obstructive Jaundice

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