An unusual case of an icteric infant with abdominal distention

Gabriel Wardi; Paul Ishimine; Daniel Lasoff; Chao Yuan; Colleen Campbell

doi:10.1016/j.jemermed.2014.01.025

An unusual case of an icteric infant with abdominal distention

J Emerg Med. 2014 Jul;47(1):18-20. doi: 10.1016/j.jemermed.2014.01.025. Epub 2014 Mar 20.

Authors

Gabriel Wardi¹, Paul Ishimine², Daniel Lasoff¹, Chao Yuan¹, Colleen Campbell¹

Affiliations

¹ Department of Emergency Medicine, UC San Diego Health System, San Diego, California.
² Department of Emergency Medicine, UC San Diego Health System, San Diego, California; Division of Pediatric Emergency Medicine, Rady's Children Hospital, San Diego, California.

PMID: 24657256
DOI: 10.1016/j.jemermed.2014.01.025

Abstract

Background: Jaundiced infants are uncommon in most emergency departments (EDs). Biliary rupture remains one of the more rare and less described causes of this condition.

Case report: A 5-month-old male presented to our ED with scleral icterus, increasing abdominal distention, and increased irritability. A bedside ultrasound revealed a moderate amount of ascites and further imaging suggested he had a rupture of his common bile duct. Surgical exploration confirmed this and revealed the presence of choledocholithiasis, which was the likely cause of the rupture. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Biliary rupture remains a rare but serious condition in very young patients. Emergency physicians should consider bedside ultrasound as an adjunct in undifferentiated abdominal distention or jaundice in this patient population.

Keywords: biliary rupture; choledocholithiasis; jaundice.

Publication types

Case Reports

MeSH terms

Ascites / etiology*
Choledocholithiasis / complications*
Choledocholithiasis / diagnosis
Common Bile Duct*
Humans
Infant
Jaundice / etiology*
Male
Rupture, Spontaneous / diagnosis
Rupture, Spontaneous / etiology