Ultrasonography in the jaundiced infant: a new approach.

Green, D; Carroll, B A

doi:10.7863/jum.1986.5.6.323

Cited by 20 publications

(9 citation statements)

References 5 publications

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“…Initial US research in BA focused on the presence or absence of the gallbladder and whether the gallbladder contracted following feeding [23–25]. The presence of a normal gallbladder (without other abnormal findings in the biliary tree) is usually thought to essentially exclude the diagnosis of BA.…”

Section: Discussionmentioning

confidence: 99%

Pseudo Gallbladder sign in biliary atresia—an imaging pitfall

et al. 2011

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BackgroundUltrasound (US) is used to identify causes of neonatal cholestasis. We describe a potential sonographic pitfall, the “pseudo gallbladder,” in biliary atresia (BA).ObjectiveTo describe the Pseudo Gallbladder sign (PsGB sign).Materials and methodsSonograms/clinical records of 20 confirmed BA infants and 20 non-BA cases were reviewed retrospectively. For the BA group, preoperative sonography and surgical and pathological findings were examined. For the non-BA group, sonographic features and pathological findings were examined. The PsGB sign is defined as a fluid-filled structure, located in the expected region of the gallbladder, measuring ≤ 15 mm in length but without a well-defined or normal-appearing gallbladder wall.ResultsA recognizable gallbladder and normal gallbladder wall were present in all non-BA infants. However, none of the BA infants had a sonographically normal gallbladder. Seventy-three percent of BA patients had a PsGB, and in 27% no gallbladder or gallbladder-like structure was detected.ConclusionA gallbladder-like structure in BA is common and can be misinterpreted as a normal gallbladder, delaying diagnosis and therapy. Recognition of this imaging pitfall, described here as the pseudo gallbladder sign, will help avoid this error.

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Section: Discussionmentioning

confidence: 99%

Pseudo Gallbladder sign in biliary atresia—an imaging pitfall

et al. 2011

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“…If the gallbladder contracts after an oral feeding, biliary atresia is generally considered unlikely [1,39]. However, several authors have already reported that normal gallbladder contraction was seen after an oral feeding in patients with type IIIa biliary atresia [33,34].…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic findings of type IIIa biliary atresia

Kim

Lee

et al. 2014

Ultrasonography

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Purpose:To describe the ultrasonographic (US) findings of type IIIa biliary atresia.Methods:We retrospectively reviewed a medical database of patients pathologically confirmed to have biliary atresia, Kasai type IIIa, between January 2002 and May 2013 (n=18). We evaluated US findings including the visible common bile duct (CBD), triangular cord thickness, gallbladder size and shape, and subcapsular flow on color Doppler US; laboratory data; and pathological hepatic fibrosis grades. We divided them into two groups-those with visible (group A) and invisible (group B) CBD on US-and compared all parameters between the two groups.Results:CBD was visible on US in five cases (27.8%; group A) and invisible in 13 cases (72.2%; group B). US was performed at an earlier age in group A than in group B (median, 27 days vs. 60 days; P=0.027) with the maximal age of 51 days. A comparison of the US findings revealed that the triangular cord thickness was smaller (4.1 mm vs. 4.9 mm; P=0.004) and the gallbladder length was larger (20.0 mm vs. 11.7 mm; P=0.021) in group A. The gallbladder shape did not differ between the two groups, and the subcapsular flow was positive in all cases of both groups. There was no significant difference in the laboratory data between the two groups. Upon pathological analysis, group A showed low-grade and group B showed low- to high-grade hepatic fibrosis.Conclusion:When CBD is visible on US in patients diagnosed with type IIIa biliary atresia, other US features could have a false negative status. A subcapsular flow on the color Doppler US would be noted in the type IIIa biliary atresia patients.

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“…Green and Carroll [12] opined that the demonstration of a decrease in gallbladder size following feeding virtually eliminates the diagnosis of biliary atresia, even in children with abnormal HIDA scans. Only one of the patients in this study did not show a change in the gall bladder size on feeding and she died even before surgery was contemplated.…”

Section: Discussionmentioning

confidence: 99%