An Unusual Case of an Icteric Infant with Abdominal Distention

• Published in: The Journal of emergency medicine Vol. 47; no. 1; pp. 18 - 20
• Main Authors: Wardi, Gabriel, MD, MPH, Ishimine, Paul, MD, Lasoff, Daniel, MD, Yuan, Chao, MD, Campbell, Colleen, MD, RDMS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2014
• Subjects: Ascites - etiology; biliary rupture; choledocholithiasis; Choledocholithiasis - complications; Choledocholithiasis - diagnosis; Common Bile Duct; Emergency; Humans; Infant; jaundice; Jaundice - etiology; Male; Rupture, Spontaneous - diagnosis; Rupture, Spontaneous - etiology; choledocholithiasis; jaundice; biliary rupture
• ISSN: 0736-4679; 2352-5029
• 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.