Pediatr Gastroenterol Hepatol Nutr.  2019 Nov;22(6):565-570. 10.5223/pghn.2019.22.6.565.

Novel Non-Surgical Interventions for Benign Inflammatory Biliary Strictures in Infants: A Report of Two Cases and Review of Current Pediatric Literature

• Reddy P
• Rivas Y
• Golowa Y
• KoganLiberman D
• Ho S
• Jan D
• Ovchinsky

• KMID: 2462096
• DOI: http://doi.org/10.5223/pghn.2019.22.6.565

Abstract

Benign biliary strictures are uncommon in children. Classically, these cases are managed surgically, however less invasive approaches with interventional radiology and or endoscopy may have similar results and improved safety profiles While benign biliary strictures have been described in literature on several occasions in young children, (most older than 1 year and once in an infant 3 months of age), all reported cases were managed surgically. We present two cases of benign biliary strictures in infants less than 6 months of age that were managed successfully with novel non-invasive procedures and a review of all current pediatric cases reported in the literature. Furthermore, we describe the use of a Rendezvous procedure, which has not been reported as a treatment approach for benign biliary strictures.

Keyword

Benign biliary strictures; Inflammatory biliary strictures; Cholestasis: Neonatal; Cholestasis: Extrahepatic/surgery; Cholestasis: Extrahepatic/etiology; Neonatal Jaundice; Infant; Hepatobiliary; ERCP; Cholangiogram

MeSH Terms

Child
Cholangiopancreatography, Endoscopic Retrograde
Constriction, Pathologic*
Endoscopy
Humans
Infant*
Infant, Newborn
Jaundice, Neonatal
Radiology, Interventional

Figure

• 

  Fig. 1 Initial magnetic resonance cholangiopancreatography and cholangiogram demonstrating biliary stricture and dilatation of intrahepatic bile ducts.

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  Fig. 2 Final cholangiogram demonstrating resolutions of both common hepatic duct and common bile duct stricture.

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  Fig. 3 Balloon dilatation of common bile duct with drainage catheter in place representing ‘Rendevous Procedure.’

Reference

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