Bile-plug syndrome

Mahr, M. Al; Hugosson, Claes; Nazer, Hisham M.; Saad, Sameh; Ali, Mohamed Ashraf

doi:10.1007/bf02388418

Cited by 14 publications

(3 citation statements)

References 11 publications

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“…When clumped together, it may mimic a polypoid tumor, a condition termed tumefactive biliary sludge. The lack of internal vascularity in sludge however distinguishers the latter from a tumor [8] . The use of newer, high resolution, ultrasound equipment is likely to aid in the diagnosis of infantile cholelithiasis.…”

Section: Discussionmentioning

confidence: 95%

Incidental ultrasound finding of cholelithiasis in an 8-week-old infant: A case report

Brakohiapa,

Brown,

Edzie

et al. 2023

Radiology Case Reports

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Section: Discussionmentioning

confidence: 95%

Incidental ultrasound finding of cholelithiasis in an 8-week-old infant: A case report

Brakohiapa,

Brown,

Edzie

et al. 2023

Radiology Case Reports

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“…In six of the nine infants with a bile‐negative test in which laparotomy ruled out BA, the final diagnosis was inspissated bile syndrome (29–31). These infants had a neonatal history of jaundice associated with hemolytic disease of the newborn due to Rh factor or blood groups AB0 incompatibility, single‐or multiple‐exchange transfusions, prematurity, and sepsis.…”

Section: Resultsmentioning

confidence: 99%

Duodenal Tube Test in the Diagnosis of Biliary Atresia

Larrosa–Haro,

Caro–López,

Coello–Ramírez

et al. 2001

J. pediatr. gastroenterol. nutr.

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BackgroundBiliary atresia (BA) is the main cause of severe liver damage in infants. Successful surgical treatment is related directly to an early and rapid diagnosis. The aim of this study was to determine specificity, sensitivity, and predictive value of the duodenal tube test (DTT) in the diagnosis of BA in a series of infants with cholestatic jaundice.MethodsThis was a descriptive study of a series of infants with cholestatic jaundice created to validate the sensitivity, specificity, and predictive value of the DTT in the diagnosis of BA. A total of 254 patients were identified from 1988 to 1998. The study cohort included 137 male infants (53.9%), and the mean age on admission was 8.3 weeks ± 2.47 weeks (standard deviation). Study protocol included liver function tests, liver ultrasound, metabolic screening and serology for viral hepatitis, and toxoplasma, rubella, cytomegalovirus, herpes, and others. A nasoduodenal tube was placed at the distal duodenum and the fluid was collected for 24 hours. DTT was considered bile positive when yellow biliary fluid was observed; the test was concluded at this time. When no yellow biliary duodenal fluid was observed, the collection was continued for 24 hours and, if negative, was reported as bile negative. The patients with a bile‐positive DTT were not explored surgically, and the cholestasis workup was completed. Laparotomy and a surgical cholangiogram were indicated in patients with bile‐negative DTT. If BA was verified, portoenterostomy was performed. The gold standard for BA diagnosis was the following: obstruction of the biliary tract confirmed by laparotomy and a surgical cholangiogram, and clinical outcome in patients without laparotomy (followed for a minimum of 18 months).ResultsThe results are as follows. BA: bile‐positive DTT, n = 3; bile‐negative DTT, n = 108. No BA: bile‐positive DTT, n = 134; bile‐negative DTT, n = 9. The following values were also determined: sensitivity, 97.3%; specificity, 93.7%; positive predictive value, 92.3%; and negative predictive value, 98.5%. The final diagnoses were as follows: BA, n = 111 (43.7%); neonatal hepatitis syndrome, n =103 (40.6%); cholestasis associated with inspissated bile syndrome, n = 13 (5.1%); choledochal cyst, n = 11 (4.3%); galactosemia, n = 9 (3.5%); cirrhosis of unknown etiology, n = 5 (2%), and Alagille syndrome, n = 2 (0.8%).ConclusionsThe data obtained from this series validate the DTT as a useful clinical tool for the differential diagnosis of the infant with cholestasis, particularly for indicating laparotomy and cholangiogram to substantiate BA. This diagnostic test is quick and simple, and offers the clinician valuable information with which to determine whether surgical intervention is necessary.

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“…The two disorders may be different, in that bile plug syndrome (synonym: gall plug syndrome) is commonly reserved for manifestations in large bile ducts, including the ampullary part (Bernstein et al 1969;Lévy et al 1979;Mahr et al 1988), whereas inspissated bile syndrome mainly involves the intrahepatic tract (Hickey and Power 1956;Breunung and Mitschke 1968;Lukacs et al 1972). However, the two terms are frequently used synonymously in the literature.…”

Section: Bile Plug Syndrome and Inspissated Bile Syndromementioning

confidence: 99%