Abstract
Three cases of bile duct perforation in children with anomalous conjugation of the pancreaticobiliary tract were presented. Case 1 was 10 month-old-boy with intraperitoneal abscess. Case 2 and 3 were 1-year-old and 3-year-old girls with panperitonitis. Case 2 and 3 were preoperatively diagnosed by abdominal echogram. and CT scan with drop infusion cholangiography. In all cases, pancreatic ducts were connected with bile ducts, and their typ e s of anomalous conjugation were III a and III b in the classification by Ohi.
In all cases with common channel dilatation, stenosis of duodenal papilla was suspected. Amylase levels in bile were remarkably high in all cases. In pathological findings of bile ducts, mucosa was preserved and slight fibrosis and massive infiltration of neutrophils were observed. We suspected that the cause of perforation was serious acute inflammation of bile duct that was caused by massive reflux of pancreatic juice with acute stenotic change of duodenal papilla.
