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MR cholangiopancreatography findings in children with spontaneous bile duct perforation

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Abstract

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.

Materials and 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.

Conclusion

In children with SBP, MRCP can depict the loculated fluid collection adjacent to the perforation site and associated bile duct anomalies.

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Authors and Affiliations

  1. 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

    Mi-Jung Lee & Myung-Joon Kim

  2. Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, 612 Eonjuro (146-92 Dogok-dong), Gangnam-gu, Seoul, 135-720, Korea

    Choon-Sik Yoon

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  1. Mi-Jung Lee
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  2. Myung-Joon Kim
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  3. Choon-Sik Yoon
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Correspondence to Myung-Joon Kim.

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Lee, MJ., Kim, MJ. & Yoon, CS. MR cholangiopancreatography findings in children with spontaneous bile duct perforation. Pediatr Radiol 40, 687–692 (2010). https://doi.org/10.1007/s00247-009-1447-7

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  • DOI: https://doi.org/10.1007/s00247-009-1447-7

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