ARTICLE TYPE : CASE REPORT
Published on : 03 Jan 2026, Volume - 1
Journal Title : WebLog Journal of Hepatology | WebLog J Hepatol
Source URL: 
https://weblogoa.com/articles/wjhp.2026.a0303
Permanent Identifier (DOI) : 
https://doi.org/10.5281/zenodo.18212957
Case Report: Neonatal Biliary Ascites Successfully Managed with Ultrasound‑Guided Peritoneal Drainage
2Formerly Head, Dept of Surgery at Tata Memorial Hospital, Mumbai, India
3J. Watumull Global Hospital & Research Centre, Delwara Road, Mount Abu, Rajasthan 307501, India Affiliated to Medical Faculty of God Fatherly Spiritual University, Mount Abu, Rajasthan, India
Abstract
Neonatal biliary ascites is a rare but important cause of progressive abdominal distension in early infancy. Diagnosis is often delayed because jaundice may be mild and stool color may remain normal. We report a term neonate presenting with increasing abdominal distention simulating bowel obstruction and respiratory compromise secondary to massive biliary ascites. Ultrasound demonstrated large-volume free fluid without biliary duct dilatation. Diagnostic paracentesis confirmed bile-stained ascites. The infant underwent therapeutic ultrasound-guided peritoneal drainage, resulting in rapid clinical improvement and stabilisation. Subsequent hepatobiliary scintigraphy demonstrated tracer extravasation consistent with spontaneous perforation of the common bile duct. Definitive surgical repair was not required with excellent recovery. This case highlights the value of early imaging, the diagnostic role of paracentesis, and the effectiveness of minimally invasive drainage as a definitive measure without further surgery. Ultrasound-guided ascitic drainage (paracentesis) for neonatal biliary ascites is a critical diagnostic and therapeutic procedure. It involves inserting a small catheter into the peritoneal cavity under local anesthesia and real-time ultrasound visualization to safely remove bile-stained fluid. This case highlights the importance of early imaging, minimally invasive stabilization, and multidisciplinary coordination in the management of neonatal bilious ascites.
Keywords: Neonatal Biliary Ascites; Spontaneous Bile Duct Perforation; Neonatal Cholestasis; Ultrasound‑Guided Peritoneal Drainage; Hepatobiliary Scintigraphy; Extrahepatic Bile Duct Perforation; Neonatal Abdominal Distension; Bilious Ascites; Neonatal Surgery; Peritoneal Drain
Citation
Govani DR, Mehta AR, Midha PK, Govani ND, Panchasara NG, Patel RR, et al. Case Report: Neonatal Biliary Ascites Successfully Managed with Ultrasound-Guided Peritoneal Drainage. WebLog J Hepatol. wjhp.2026.a0303. https://doi.org/10.5281/zenodo.18212957