Obstructive choledocholithiasis requiring intervention in a three week old neonate: A case report and review of the literature

• Choledocholithiasis are rare in neonates.
• Many cases resolve spontaneously with the use of antibiotics and ursodeoxycholic acid.
• Operative intervention is needed in patients who develop cholangitis or who fail to pass the stone.

The discovery of cholelithiasis in neonates is often incidental, however obstructing common bile duct stones are rare. Herein we report the case of a 3 week old neonate who presented with obstructive choledocholithiasis. The patient was treated conservatively with antibiotics and ursodeoxycholic acid but did not improve. He was therefore taken to surgery for cholecystectomy and stone extraction. The operation was successful and his transaminases and bilirubin levels declined. Trials of conservative management can be attempted in asymptomatic infants with choledocholithiasis. However, failure of the stone to pass or ongoing signs of cholecystitis should be met with operative intervention to remove the obstruction.