Volume 97, Issue 2 pp. 246-249

Neonatal sepsis presenting as a choledochal cyst

Ron Shaoul,

Ron Shaoul

Departments of Pediatrics, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel

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Igor Sukhotnik,

Igor Sukhotnik

Pediatric Surgery, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel

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Aurora Toubi,

Aurora Toubi

Radiology, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel

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Ron Shaoul,

Ron Shaoul

Departments of Pediatrics, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel

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Igor Sukhotnik,

Igor Sukhotnik

Pediatric Surgery, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel

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Aurora Toubi,

Aurora Toubi

Radiology, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel

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First published: 30 January 2008

https://doi.org/10.1111/j.1651-2227.2007.00609.x

Citations: 3

Correspondence
Ron Shaoul, M.D., Head, Pediatric Day Care Unit, Department of Pediatrics, Bnai Zion Medical Center, 47 Golomb St., POB 4940, Haifa 31048, Israel. Tel: +(972)-4-8359662 | Fax: +(972)-4-8359724 | Email: [email protected]

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Abstract

We report a case of a neonate who presented with Klebsiella sepsis and a fusiform dilation of the common bile duct on ultrasound suspected to be a choledochal cyst type Ia. In addition, a biliary sludge was noted in the gallbladder. All findings resolved with resolution of the sepsis. We discuss the case and review the literature regarding the association of sepsis with cholestasis and biliary sludge.

Conclusions: we suggest that in any case of sepsis presenting as a choledochal cyst, it is essential to repeat the ultrasound after complete recovery before a surgery is planned.

References

1 Geier A, Fickert P, Trauner M. Mechanisms of disease: mechanisms and clinical implications of cholestasis in sepsis. Nat Clin Pract Gastroenterol Hepatol 2006; 3: 574–85.
10.1038/ncpgasthep0602
CAS PubMed Web of Science® Google Scholar
2 Chand N, Sanyal AJ. Sepsis-induced cholestasis. Hepatology 2007; 45: 230–41.
10.1002/hep.21480
CAS PubMed Web of Science® Google Scholar
3 Moseley RH. Sepsis-associated cholestasis. Gastroenterology 1997; 112: 302–6.
10.1016/S0016-5085(97)70250-6
CAS PubMed Web of Science® Google Scholar
4 Moseley RH. Sepsis and cholestasis. Clin Liver Dis 2004; 8: 83–94.
10.1016/S1089-3261(03)00134-X
PubMed Google Scholar
5 Kerkar N, Norton K, Suchy FJ. The hepatic fibrocystic diseases. Clin Liver Dis 2006; 10: 55–71, v–vi.
10.1016/j.cld.2005.10.003
PubMed Google Scholar
6 Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg 1977; 134: 263–9.
10.1016/0002-9610(77)90359-2
CAS PubMed Web of Science® Google Scholar
7 Bolder U, Ton-Nu HT, Schteingart CD, Frick E, Hofmann AF. Hepatocyte transport of bile acids and organic anions in endotoxemic rats: impaired uptake and secretion. Gastroenterology 1997; 112: 214–25.
10.1016/S0016-5085(97)70238-5
CAS PubMed Web of Science® Google Scholar
8 Moseley RH, Wang W, Takeda H, Lown K, Shick L, Ananthanarayanan M, et al. Effect of endotoxin on bile acid transport in rat liver: a potential model for sepsis-associated cholestasis. Am J Physiol 1996; 271(1 Pt 1): G137–46.
CAS PubMed Web of Science® Google Scholar
9 Nolan JP. Intestinal endotoxins as mediators of hepatic injury – an idea whose time has come again. Hepatology 1989; 10: 887–91.
10.1002/hep.1840100523
CAS PubMed Web of Science® Google Scholar
10 Trauner M, Meier PJ, Boyer JL. Molecular pathogenesis of cholestasis. N Engl J Med 1998; 339: 1217–27.
10.1056/NEJM199810223391707
CAS PubMed Web of Science® Google Scholar
11 Utili R, Abernathy CO, Zimmerman HJ. Cholestatic effects of Escherichia coli endotoxin endotoxin on the isolated perfused rat liver. Gastroenterology 1976; 70: 248–53.
CAS PubMed Web of Science® Google Scholar
12 Utili R, Abernathy CO, Zimmerman HJ. Inhibition of Na+, K+-adenosinetriphosphatase by endotoxin: a possible mechanism for endotoxin-induced cholestasis. J Infect Dis 1977; 136: 583–7.
10.1093/infdis/136.4.583
CAS PubMed Web of Science® Google Scholar
13 Franson TR, Hierholzer WJ Jr., LaBrecque DR. Frequency and characteristics of hyperbilirubinemia associated with bacteremia. Rev Infect Dis 1985; 7: 1–9.
10.1093/clinids/7.1.1
CAS PubMed Web of Science® Google Scholar
14 Shamir R, Maayan-Metzger A, Bujanover Y, Ashkenazi S, Dinari G, Sirota L. Liver enzyme abnormalities in gram-negative bacteremia of premature infants. Pediatr Infect Dis J 2000; 19: 495–8.
10.1097/00006454-200006000-00001
CAS PubMed Web of Science® Google Scholar
15 De RL, Pecorari R, Contiero MR. Cholestasis associated with sepsis in newborns. Pediatr Med Chir 1993; 15: 53–5.
Google Scholar
16 Kishan J, Mir NA, Elzouki AY. Neonatal cholestatic jaundice with Klebsiella septicemia. Indian Pediatr 1984; 21: 865–8.
CAS PubMed Google Scholar
17 Minuk GY, Rascanin N, Sarjeant ES, Pai CH. Sepsis and cholestasis: the in vitro effects of bacterial products on 14C-taurocholate uptake by isolated rat hepatocytes. Liver 1986; 6: 199–204.
10.1111/j.1600-0676.1986.tb01066.x
CAS PubMed Web of Science® Google Scholar
18 Nishida T, Huang TP, Seiyama A, Hamada E, Kamiike W, Ueshima S, et al. Endothelin A-receptor blockade worsens endotoxin-induced hepatic microcirculatory changes and necrosis. Gastroenterology 1998; 115: 412–20.
10.1016/S0016-5085(98)70208-2
CAS PubMed Web of Science® Google Scholar
19 Goldberg PK, Kozinn PJ, Kodsi B, Lewitis R, Ackerman B, Aschenbrand L, et al. Endotoxemia and hyperbilirubinemia in the neonate. Am J Dis Child 1982; 136: 845–8.
CAS PubMed Web of Science® Google Scholar
20 Pazzi P, Gamberini S, Buldrini P, Gullini S. Biliary sludge: the sluggish gallbladder. Dig Liver Dis 2003; 35(Suppl. 3): S39–45.
10.1016/S1590-8658(03)00093-8
PubMed Web of Science® Google Scholar
21 Messing B, Bories C, Kunstlinger F, Bernier JJ. Does total parenteral nutrition induce gallbladder sludge formation and lithiasis? Gastroenterology 1983; 84(5 Pt 1): 1012–9.
PubMed Web of Science® Google Scholar
22 Ko CW, Lee SP. Gastrointestinal disorders of the critically ill. Biliary sludge and cholecystitis. Best Pract Res Clin Gastroenterol 2003; 17: 383–96.
10.1016/S1521-6918(03)00026-X
CAS PubMed Web of Science® Google Scholar
23 Holcomb GW, Jr., Holcomb GW, III. Cholelithiasis in infants, children, and adolescents. Pediatr Rev 1990; 11: 268–74.
10.1542/pir.11-9-268
PubMed Google Scholar
24 Debray D, Pariente D, Gauthier F, Myara A, Bernard O. Cholelithiasis in infancy: a study of 40 cases. J Pediatr 1993; 122: 385–91.
10.1016/S0022-3476(05)83421-3
CAS PubMed Web of Science® Google Scholar
25 Wilcox DT, Casson D, Bowen J, Thomas A, Bruce J. Cholelithiasis in early infancy. Pediatr Surg Int 1997; 12: 198–9.
10.1007/BF01350001
CAS PubMed Web of Science® Google Scholar

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Volume97, Issue2

February 2008

Pages 246-249

Neonatal sepsis presenting as a choledochal cyst

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Neonatal sepsis presenting as a choledochal cyst

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