Case Report
Spontaneous Rupture of Common Hepatic Duct in an Infant, a Rare Entity
Ranya Herzallah*,
Samer Al-Rahamneh,
Qusay Altarawneh,
Sarah Abuqubu
Issue:
Volume 11, Issue 3, September 2025
Pages:
114-118
Received:
9 May 2025
Accepted:
26 May 2025
Published:
23 June 2025
Abstract: Pediatric spontaneous biliary duct perforation (SBDP) represents a rare clinical condition. The vast majority of pediatric cases typically manifest around 6 months of age; however, the initial onset of this condition has been documented to occur as early as 25 weeks of gestation and, conversely, as late as 7 years postnatally. Despite the encouraging fact that the condition is treatable with appropriate intervention, the often non-specific nature of its associated symptoms and signs can unfortunately result in a significantly delayed diagnosis. This delay, in turn, carries the potential for the development of severe, life-threatening conditions such as biliary peritonitis and sepsis. Therefore, it is of paramount importance for clinicians to establish an early suspicion and achieve a prompt diagnosis to mitigate these risks. An exceptionally uncommon variant within the spectrum of spontaneous biliary duct perforation is the spontaneous rupture of the common hepatic duct. This report presents an illustrative case of a 5-month-old male infant who experienced a spontaneous perforation of the common hepatic duct, leading to the formation of a biloma. This diagnosis was successfully established pre-operatively through the utilization of a contrasted abdominal computed topography (CT) scan. Subsequently, the patient underwent a primary surgical repair of the identified perforation site, in addition to percutaneous drainage facilitated by a biliary T-tube. The postoperative recovery period was remarkably uneventful, and the T-tube was successfully removed on the 12th postoperative day. Six weeks following discharge from the hospital, the patient exhibited entirely satisfactory progress, with a complete absence of any discernible complications.
Abstract: Pediatric spontaneous biliary duct perforation (SBDP) represents a rare clinical condition. The vast majority of pediatric cases typically manifest around 6 months of age; however, the initial onset of this condition has been documented to occur as early as 25 weeks of gestation and, conversely, as late as 7 years postnatally. Despite the encouragi...
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Research Article
Risk Factors for Mortality in Septic Children with Acute Kidney Injury in the Pediatric Intensive Care Unit
Issue:
Volume 11, Issue 3, September 2025
Pages:
119-126
Received:
23 May 2025
Accepted:
9 June 2025
Published:
4 July 2025
Abstract: Acute Kidney Injury (AKI) and sepsis are major causes of morbidity and mortality in pediatric intensive care units (PICUs), especially when they occur concurrently. Despite advancements in critical care, the identification of risk factors remains essential to improve survival outcomes in children. To determine the risk factors associated with mortality in children diagnosed as sepsis with treated in the PICU. This was an observational analytic study with a case-control design, conducted in the PICU of Prof. Dr. I. G. N. G. Ngoerah Hospital from 2022 to 2024. Pediatric patients aged 1 month to <18 years with diagnoses of AKI and sepsis were included. Variables analyzed included nutritional status, duration of PICU stay, requirement of mechanical ventilation, involvement of a pediatric nephrologist, history of nephrotoxic drug use, and the number of nephrotoxic drugs used. Bivariate and multivariate analyses were performed using logistic regression. Total of 126 patients were analyzed. Bivariate analysis showed a significant relationship between mortality and the need for mechanical ventilation (OR 6.2; p 0.001) and the absence of pediatric nephrology care (OR 2.1; p = 0.047). In multivariate analysis, the need for mechanical ventilation (OR 16.5; 95% CI 3.5-77.2; p = 0.001) and pediatric nephrology care (OR 6.7; 95% CI 1.6-28.0; p = 0.009) were independently associated with mortality. The need for mechanical ventilation and the lack of pediatric nephrology consultation are significant risk factors for mortality in septic children with AKI treated in the PICU.
Abstract: Acute Kidney Injury (AKI) and sepsis are major causes of morbidity and mortality in pediatric intensive care units (PICUs), especially when they occur concurrently. Despite advancements in critical care, the identification of risk factors remains essential to improve survival outcomes in children. To determine the risk factors associated with morta...
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,
Gusti Ayu Putu Nilawati
