Sonography of the normal pediatric gallbladder and biliary tract.

Abstract

Fifty-one pediatric patients (range, 1 mo. to 16 yr.), all of whom had normal clinical findings and laboratory data pertaining to the gallbladder and biliary tract, were examined by ultrasound. Scans showed a gradual increase in the size of the gallbladder with age; only one patient had a gallbladder diameter greater than 3.5 cm or a length greater than 7.5 cm. Wall thickness could be measured in 45 patients and was never more than 3 mm. The lumen of the common hepatic duct gradually increased with age but was never greater than 4 mm. The right portal vein also showed a gradual increase with age.

Comparison of ultrasound and biopsy findings in children with cystic fibrosis related liver disease

“…A wall thickness greater than 3 mm was considered abnormal [23]. Presence or absence of gallstones was noted.…”

“…Presence or absence of gallstones was noted. The diameter of the common bile duct was assessed and considered as normal if smaller than 4 mm [23]. Spleen size was regarded normal if the spleen did not extend over the inferior margin of the left kidney [24].…”

Transient gallbladder distention in sick premature infants: the value of ultrasonography and radionuclide scintigraphy

“…Recent attempts at establishing normal and abnormal ultrasonographic measurements should be helpful in that respect [16,17]. Caroll et al, in their study of the neonatal biliary system using real time ultrasound, found no statistically significant difference between the lengths of normal gallbladders and those felt as upper quadrant masses but the gallbladder width was significantly increased in those with masses [17].…”

“…It is also valuable in detecting stones or sludge in the gallbladder and bile ducts and in evaluating the size of these ducts [6,16,17]. However, ultrasonography has its limitations.…”

Management of Gallstones in the Pediatric Patient

“…Photo courtesy of Dr. Shaun Steigman right upper quadrant/epigastric pain along with a transabdominal ultrasound depicting gallstones or sludge, gallbladder wall thickening, an enlarged/distended gallbladder, pericholecystic fl uid, and/or a sonographic Murphy's sign confi rms or at least solidifi es the diagnosis. Normal gallbladder wall thickness in children under 16 years of age is ≤3 mm [ 25 ]. The positive predictive value of ultrasound in pediatric cholecystitis is reported to be 67-87 % [ 26 ].…”