Safra kesesi perforasyonu ve Crigler-najjar sendromu

Akut taşsız kolesistitli 10 yaşındaki bir erkek çocukta, antibiyotik tedavisi altındayken safra kesesi perforasyonu gelişti. Laparotomide, safra kesesi peıforasyonuna ikincil biliyer peritonit saptandı ve kolesistektomi yapıldı. Hafif hiperbilirıtbinemi dışında hastanın ameliyat sonrası dönemi sorunsuzdu, inceleme sonucunda, Crigler-Najjar tip 2 sendromu saptandı ve fenobarbital tedavisi başlandı. Safra kesesi perforasyonu ve Crigler-Najjar sendromunun ikisi de çocukluk çağındaki nadir hastalıklardır ve İngilizce yayınlanan literatürde bu iki hastalığın birlikteliğine rastlanmamıştır.

Perforation of the gallbladder and Crigler-najjar syndrome

A case of acute acalculous cholecystitis in a ten-year-old boy presented with perforation of the gallbladder under antibiotic therapy. A biliary peritonitis secondary to gallbladder perforation was observed during laparotomy, and cholecystectomy was performed. Except mild hyperbiliruhinemia, his postoperative period was uneventful. After investigation, Crigler-Najjar syndrome type 2 was detected and phénobarbital therapy was started. Both perforation of the gallbladder and Crigler-Najjar syndrome are uncommon diseases in childhood, and occurrence of these two diseases together was not previously reported in English-language literature.

Kaynakça

1. Jansen PLM: Diagnosis and management of Crigler- Najjar syndrome. Eur J Pediatr 158:89, 1999 2. Ohkawa H, Takahashi H, Maie M: A malformation of the pancreatico-biliary system as a cause of perforation of the biliary tract in childhood. J Pediatr Surg 12:541, 1977 3. Riesenfeld G: Perforation of the gallbladder. Int Surg 52:218, 1969 4. Sinaasappel M, Jansen PLM: The differential diagnosis of Crigler-Najjar disease, types 1 and 2, by bile pigment analysis. Gastroenterology 100:783, 1991 5. Stephenson CA, Atkinson G, Ball TI: Unusual presentation of perforation of the gallbladder. Pediatr Radiol 21:358, 1991 6. Suchy FJ: Diseases of the gallbladder. Berhman RE, Kliegman RM, Arvin AM (eds): Nelson Textbook of Pediatrics. Philadelphia, Pennsylvania, WB Saunders 1996, p: 1154

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