J.Jpn. Surg. Soc.. 121(5): 517-521, 2020

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Feature topic

SURGICAL TREATMENT FOR ACUTE ABDOMEN CAUSED BY THE BILIARY SYSTEM IN CHILDREN

Acute abdomen caused by the biliary tract is a very rare condition in children because although gallstones are a common condition in adults they are uncommon in pediatrics. In children, gallbladder torsion and perforation of the biliary tract with congenital biliary dilatation are major causes of biliary emergency. Gallbladder torsion due to congenital floating gallbladder leads to vascular insufficiency, resulting in rapid necrosis of the gallbladder, and the pediatric type tends to be twisted more markedly compared with the adult type. The cause of biliary tract perforation is mostly obstruction due to protein plug formation with pancreaticobiliary maljunction. Recently, as the development of medical imaging technologies has improved emergency diagnostic accuracy, it is expected that laparoscopic surgery and single-incision laparoscopic surgery may be performed in the future even in pediatric emergency of the biliary tract.

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