OBSTRUCTIVE-JAUNDICE, AN UNUSUAL INITIAL MANIFESTATION OF INTRAABDOMINAL NON-HODGKINS-LYMPHOMA IN CHILDREN - COMPLICATIONS OF PERCUTANEOUS TRANSHEPATIC CHOLANGIAL DRAINAGE

Obstructive jaundice is an unusual initial manifestation of non-Hodgki n's lymphoma in children. Two pediatric patients with primary intraabd ominal non-Hodgkin's lymphoma causing obstructive jaundice are present ed. Although percutaneous transhepatic cholangial drainage (PTCD) is f requently used to treat obstructive jaundice, there was no definite ru le for management of PTCD during chemotherapy, which may rapidly resol ve the obstruction. Biliary peritonitis occurred in both patients soon after removal of the PTCD tube after chemotherapy. It was speculated that secure formation of the fistula for PTCD was impaired because of chemotherapy for a considerably long period. The PTCD tube that was al ready placed for obstructive jaundice in a non-Hodgkin's lymphoma pati ent should be maintained during chemotherapy with great care for displ acement of the tube. PTCD can result in complications, and is probably unnecessary when lymphoma has been diagnosed before PTCD. Copyright ( C) 1997 by W.B. Saunders Company.