PEDIATRICS Vol. 77 No. 6 June 1986, pp. 858-861
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Common Bile Duct Obstruction Due to an Intraluminal Mass of Candidiasis in a Previously Healthy Child

Henrik Carstensen MD1, Karl Olof Nilsson MD1, Sven-Caspar Nettelblad MD1, Claes-Göran Cederlund MD1, and Jan Hildell MD1

1 From the Departments of Paediatrics, Surgery, and Radiology, University of Lund, Malmö General Hospital, Malmö, Sweden

A 36/12-year-old previously healthy girl had intermittent attacks of abdominal pain following a blunt abdominal trauma. At admission to the hospital, she had jaundice and hepatomegaly. Results of laboratory tests indicated an obstructive pattern, and ultrasonography revealed an intraluminal mass in the distal common bile duct. At surgery, the mass was confirmed as the cause of obstruction, and it was removed. Microscopic analysis indicated that the amorphous material was fungi infested. Growth cultures from bile and feces yielded Candida albicans. Postoperative treatment with T-tube drainage and antimycotic drugs led to an uneventful recovery. Clinical, biochemical, and ultrasonographic follow-up have shown no evidence of recurrence. A possible cause and effect relationship between the trauma and the development of biliary obstruction is suggested.

Key Words: biliary candidiasis • abdominal ultrasonography • trauma • ketoconazole • common bile duct obstruction

Submitted on December 27, 1983
Accepted on August 1, 1985