To explore the value and key points of ultrasound examination in the diagnosis of biliary tract perforation in children.

A retrospective analysis was performed on the clinical data and ultrasound sonograms of 41 children diagnosed with biliary tract perforation at Children's Hospital of Chongqing Medical University from September 1996 to June 2019.

Main clinical manifestations included vomiting (n=31), abdominal pain (n=23), abdominal distension (n=21), fever (n=18), jaundice (n=8), and positive peritoneal irritation (n=25). Abdominal ultrasound examination of the 41 children with biliary tract perforation revealed 38 cases with bile duct abnormalities (including 31 cases with biliary dilatation, 20 cases with gallbladder wall thickening, and 2 cases with gallbladder stones), 4 cases with diminished gallbladder filling during fasting state, and 36 cases with ascites. Ultrasound showed that the sensitivity and specificity of biliary dilation for diagnosing biliary tract perforation were 90.63% and 77.78%, respectively, and those of gallbladder wall thickening were 78.26% and 88.89%, respectively.

For children with symptoms such as bloating, vomiting, fever, and jaundice, abnormal biliary tract (dilated biliary tract, thickened biliary wall, biliary stones, etc.) revealed by ultrasound, and unexplained ascites, further examination during fasting state is required. If diminished gallbladder filling is found, biliary tract perforation is suggested. Ultrasound examination can be used as a reliable tool to assist in the diagnosis of biliary tract perforation in children.