Journal List > Korean J Pediatr Gastroenterol Nutr > v.13(2) > 1043473

Korean J Pediatr Gastroenterol Nutr. 2010 Sep;13(2):204-209. Korean.
Published online September 30, 2010.  https://doi.org/10.5223/kjpgn.2010.13.2.204
Copyright © 2010 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
A Case of Obstructive Jaundice Secondary to Traumatic Pancreatitis Treated with Percutaneous Transhepatic Biliary Drainage
Ji Sook Park, M.D., Jong Geun Baek, M.D., Jung Sook Yeom, M.D., Eun Sil Park, M.D., Ji-Hyun Seo, M.D., Jea-Young Lim, M.D., Chan-Hoo Park, M.D., Hyang-Ok Woo, M.D., Hee-Shang Youn, M.D., and Tae Beom Shin, M.D.*
Department of Pediatrics, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea.
*Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea.

Corresponding author (Email: hsyoun@gnu.ac.kr )
Received August 07, 2010; Revised August 11, 2010; Accepted September 03, 2010.

Abstract

Isolated pancreatic trauma and secondary obstructive jaundice in the pediatric population is unusual. Biliary tract obstruction can be a major cause of acute pancreatitis. We report a case of obstructive jaundice secondary to isolated traumatic acute pancreatitis in a previously healthy 32-month-old girl. In our case, secondary obstructive jaundice aggravated the pancreatic inflammation and was successfully treated with percutaneous transhepatic biliary drainage (PTBD).

Keywords: Trauma; Pancreatitis; Obstructive jaundice

Figures


Fig. 1
Whole abdominal computed tomography was performed on admission (A, B) showing diffuse pancreatic swelling and peripancreatic fluid collection (arrows), a relatively intact common bile duct (solid arrow), and a part of the gallbladder (dotted arrow), and 10 days after admission (C) showing intra- and extra-hepatic biliary duct dilatation (arrow) and milder pancreatic swelling and a decreased amount of peripancreatic fluid collection than before.
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Fig. 2
Magnetic resonance cholangiopancreaticography was performed 28 days after admission showing a distended gallbladder, dilated biliary trees, and pancreatic duct (dotted arrow) and low signal lesion suggestive of a biliary stone in the distal common bile duct (solid arrow) and biliary sludge in the gallbladder.
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Fig. 3
Cholangiograms through the percutaneous transhepatic biliary drainage catheter were performed 33 days after admission (A) showing marked dilated intra- and extra-hepatic bile ducts, and a smooth, tapering biliary stricture in the distal common bile duct (solid arrow), and 35 days after admission (B) showing a mild dilated pancreatic duct and a filling defect (dotted arrow) in the distal common bile duct suggestive of a biliary stone which was removed by a skilled interventional radiologist via a stone basket and shown to be a small amount of biliary sludge, and 66 days after admission (C) showing no biliary dilatation or stricture of the common bile duct with free flow of contrast media from the common bile duct to the second portion of the duodenum.
Click for larger image


Fig. 4
Serial changes of laboratory findings, (A) serum amylase and lipase, (B) serum total bilirubin and direct bilirubin according to days after admission show temporal relationsship with (A) and (B).
Click for larger image

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