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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2024; 08(01): 056-059
DOI: 10.1055/s-0043-1774721
Case Report

Successful Treatment of Refractory Inspissated Bile Syndrome Using Gastrografin

Justin J. Guan 
1   Department of Radiology, Division of Interventional Radiology, Cleveland Clinic, Moreland Hills, Ohio, United States
,
Mohammad A. Amarneh
2   Department of Radiology, Division of Interventional Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
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Abstract

Inspissated bile syndrome (IBS) is a rare cause of obstructive jaundice in infants. Despite drainage and irrigation, obstruction may persist in some cases with limited further options. This report presents a case of persistent IBS in a 5-month-old female with worsening liver failure despite cholecystostomy and saline irrigation, and a last-ditch effort was made to irrigate with Gastrografin. Patient's bilirubin decreased from 15.5 to 8.3 mg/dL after 1 day. Her bilirubin and liver functions tests normalized by 2 weeks. Gastrografin's hyperosmolarity promotes intraluminal fluid shift and stimulates smooth muscle contraction, which may explain its effectiveness in treating refractory IBS.

Keywords

inspissated bile syndrome - IBS - Gastrografin


Publication History

Article published online:
19 October 2023

© 2023. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Bollu BK, Dawrant MJ, Thacker K. et al. Inspissated bile syndrome; safe and effective minimally invasive treatment with percutaneous cholecystostomy in neonates and infants. J Pediatr Surg 2016; 51 (12) 2119-2122
    CrossrefPubMedGoogle Scholar
  • 2 Berger S, Schibli S, Stranzinger E, Cholewa D. One-stage laparoscopic surgery for inspissated bile syndrome: case report and review of surgical techniques. Springerplus 2013; 2: 648
    CrossrefPubMedGoogle Scholar
  • 3 Berrani H, Vasies I, Cron J, Bachy B, Le Dosseur P, Mouterde O. Association of N-acetylcysteine and glucagon during percutaneous cholangiography in the treatment of inspissated bile syndrome. Arch Pediatr 2015; 22 (03) 300-302
    CrossrefPubMedGoogle Scholar
  • 4 Jun WY, Cho MJ, Han HS, Bae SH. Use of Omega-3 polyunsaturated fatty acids to treat inspissated bile syndrome: a case report. Pediatr Gastroenterol Hepatol Nutr 2016; 19 (04) 286-290
    CrossrefPubMedGoogle Scholar
  • 5 Ekladious A, Wheeler LP, Yamanaka M. Gastrografin: a diagnostic and therapeutic agent. Intern Med J 2018; 48 (12) 1547-1549
    CrossrefPubMedGoogle Scholar