Bile-plug syndrome (inspissated bile syndrome) is a correctable cause of obstructive jaundice in infants. Formerly thought to be a common cause of neonatal jaundice, the presence of thick bile in the extrahepatic ducts is now usually felt to represent a result of a hepatic disorder (hepatitis) rather than the primary cause of the abnormality. Operative cholangiography has shown, however, occasional cases of neonatal jaundice with a definite obstructing bile-plug. Bile-plug syndrome usually occurs in neonates with sepsis (as in this case), acute dehydration, and massive hemolysis due to Rh or ABO incompatibility. A three-week-old infant with this syndrome who presented with a direct bilirubin of 5 mg/dl is reported. Antibiotic therapy and hydration resulted in complete improvement in five days.
From the Department of Radiology, Children's Hospital of Wisconsin, Milwaukee, Wisconsin