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Niknam R, Mortazavi SMM, Jahromi MG, Davoodi M, Soheili M, Ataollahi M, Moshfeghinia R. Stone removal in a 5-year-old child with extrahepatic biliary obstruction using ERCP: A case report and a mini-review. Clin Case Rep 2023; 11:e7620. [PMID: 37520769 PMCID: PMC10374985 DOI: 10.1002/ccr3.7620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/03/2023] [Accepted: 06/13/2023] [Indexed: 08/01/2023] Open
Abstract
Key Clinical Message ERCP is a safe and effective method for managing biliary obstruction in children. A case report illustrates successful removal of a bile duct stone in a 5-year-old child using ERCP. Pediatric ERCP is a viable option for treating biliary diseases in well-equipped centers, alongside other approaches. Abstract We describe a 5-year-old child with extrahepatic biliary stone who successfully underwent endoscopic retrograde cholangiopancreatography for stone removal. He suffered from persistent colicky abdominal pain accompanied by fever that confirmed biliary stone. ERCP along with other methods, can be considered a safe procedure for managing BD in children.
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Affiliation(s)
- Ramin Niknam
- Gastroenterohepatology Research CenterShiraz University of Medical SciencesShirazIran
| | - Seyede Maryam Mahdavi Mortazavi
- Pediatric Gastroenterology Fellowship, Department of Pediatrics, School of MedicineNamazi teaching Hospital Shiraz University of Medical SciencesShirazIran
| | - Mehdi Ghaderian Jahromi
- Medical Imaging Research Center, Radiology DepartmentShiraz University of Medical SciencesShirazIran
| | - Marzieh Davoodi
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Marzieh Soheili
- College of PharmacyWestern New England UniversitySpringfieldUSA
| | - Maryam Ataollahi
- Department of Pediatrics, School of Medicine Namazi teaching HospitalAbu Ali Sina for Medicine & Organ transplant Shiraz University of Medical SciencesShirazIran
| | - Reza Moshfeghinia
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
- USERN officeShiraz University of Medical SciencesShirazIran
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Killelea P, Sakhuja S, Hernandez J, Hicks MJ, Harpavat S. Rolling stones: an instructive case of neonatal cholestasis. BMC Pediatr 2022; 22:526. [PMID: 36058901 PMCID: PMC9441063 DOI: 10.1186/s12887-022-03560-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/21/2022] [Indexed: 11/27/2022] Open
Abstract
Background Jaundice within the first 1–2 weeks of a neonate’s life will generally self-resolve; however, if it lasts longer than this time frame it warrants further work up. Direct or conjugated hyperbilirubinemia can suggest neonatal cholestasis, which in turn reflects marked reduction in bile secretion and flow. The differential diagnosis for neonatal cholestasis is broad. Neonatal choledocholithiasis is a rare cause of neonatal cholestasis, but should be considered on the differential diagnosis for patients presenting with elevated conjugated bilirubin. Case presentation We describe an infant who presented with neonatal cholestasis. He subsequently underwent work up for biliary atresia, as this is one of the more time-sensitive diagnoses that must be made in neonates with conjugated hyperbilirubinemia. He was ultimately found to have choledocholithiasis on magnetic resonance cholangiopancreatography. He was managed conservatively with optimizing nutrition and ursodeoxycholic acid therapy. Conclusions We found that conservative management, specifically optimizing nutrition and treating with ursodeoxycholic acid, can be a sufficient approach to facilitating resolution of the choledocholithiasis and conjugated hyperbilirubinemia. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03560-3.
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Affiliation(s)
- Paige Killelea
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine and Texas Children's Hospital, 6621 Fannin St., Mark Wallace Tower Suite 1010, Houston, TX, 77030, USA
| | - Shruti Sakhuja
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine and Texas Children's Hospital, 6621 Fannin St., Mark Wallace Tower Suite 1010, Houston, TX, 77030, USA.,Department of Radiology, Baylor College of Medicine and Texas Children's Hospital, 6621 Fannin St., Mark Wallace Tower Suite 1010, Houston, TX, USA
| | - Jose Hernandez
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine and Texas Children's Hospital, 6621 Fannin St., Mark Wallace Tower Suite 1010, Houston, TX, 77030, USA.,Department of Radiology, Baylor College of Medicine and Texas Children's Hospital, 6621 Fannin St., Mark Wallace Tower Suite 1010, Houston, TX, USA
| | - M John Hicks
- Department of Pathology, Baylor College of Medicine and Texas Children's Hospital, 6621 Fannin St., Mark Wallace Tower Suite 1010, Houston, TX, USA
| | - Sanjiv Harpavat
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine and Texas Children's Hospital, 6621 Fannin St., Mark Wallace Tower Suite 1010, Houston, TX, 77030, USA. .,Department of Radiology, Baylor College of Medicine and Texas Children's Hospital, 6621 Fannin St., Mark Wallace Tower Suite 1010, Houston, TX, USA.
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