Conservative treatment of spontaneous biliary perforation.

Spontaneous perforation of the extrahepatic bile ducts (spontaneous biliary perforation; SBP) is one of the commonest surgical causes of jaundice after biliary atresia and the second leading cause of surgical jaundice in infancy. Awareness of this condition is important to avoid diagnostic pitfalls. After its first description, published by Dijkstra in 1932, roughly 150 cases have been reported in the literature, and nowadays SBP is a well-recognized entity. We describe the case of a 4-week-old boy who presented with insidious onset of neonatal cholestatic icterus. Although the diagnosis of biliary perforation was made we successfully opted for a conservative approach.