Ultrasound Findings in Paediatric Cholestasis: How to Image the Patient and What to Look for

Overview

Journal J Ultrasound

Publisher Springer

Specialty Radiology

Date 2019 Feb 14

PMID 30756259

Citations 6

Authors

Marco Di Serafino

Matilde Gioioso

Rosa Severino

Francesco Esposito

Norberto Vezzali

Federica Ferro

Piernicola Pelliccia

Maria Grazia Caprio

Raffaele Iorio

Gianfranco Vallone

Affiliations

Soon will be listed here.

Abstract

Paediatric biliary tract and gallbladder diseases include a variety of entities with a wide range of clinical presentations. Cholestasis represents an impaired secretion of bilirubin by hepatocytes, manifesting with high blood levels of conjugated bilirubin and jaundice. Various causes may be involved, which can be recognised analysing blood tests and hepatobiliary imaging, while sometimes liver biopsy or surgery may be necessary. High-resolution real-time ultrasonography is an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. In this paper, we briefly review the normal anatomy and the ultrasound aspects of main pathologies affecting gallbladder and biliary tree in neonatal and paediatric age.

Citing Articles

Biliary atresia in a 3-month-old infant (case report).

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Diagnostic Efficacy of Advanced Ultrasonography Imaging Techniques in Infants with Biliary Atresia (BA): A Systematic Review and Meta-Analysis.

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Protocols of Investigation of Neonatal Cholestasis-A Critical Appraisal.

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Development and Assessment of Screening Nomogram for Biliary Atresia Based on Hepatobiliary Ultrasonographic Features.

Dai S, Sun Y, Wu Y, Chen G, Sun S, Dong R Front Pediatr. 2021; 9:625451.

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References

Balistreri W, Grand R, Hoofnagle J, Suchy F, Ryckman F, Perlmutter D . Biliary atresia: current concepts and research directions. Summary of a symposium. Hepatology. 1996; 23(6):1682-92. DOI: 10.1002/hep.510230652. View

Sato M, Ishida H, Konno K, Naganuma H, Ishida J, Hirata M . Choledochal cyst due to anomalous pancreatobiliary junction in the adult: sonographic findings. Abdom Imaging. 2001; 26(4):395-400. DOI: 10.1007/s002610000184. View

Han S, Kim M, Han A, Chung K, Yoon C, Kim D . Magnetic resonance cholangiography for the diagnosis of biliary atresia. J Pediatr Surg. 2002; 37(4):599-604. DOI: 10.1053/jpsu.2002.31617. View

Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K . Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg. 1977; 134(2):263-9. DOI: 10.1016/0002-9610(77)90359-2. View

Poffenberger C, Gausche-Hill M, Ngai S, Myers A, Renslo R . Cholelithiasis and its complications in children and adolescents: update and case discussion. Pediatr Emerg Care. 2012; 28(1):68-76. DOI: 10.1097/PEC.0b013e31823f5b1e. View

Jeanty C, Derderian S, Courtier J, Hirose S . Clinical management of infantile cholelithiasis. J Pediatr Surg. 2015; 50(8):1289-92. DOI: 10.1016/j.jpedsurg.2014.10.051. View

Rothstein D, Harmon C . Gallbladder disease in children. Semin Pediatr Surg. 2016; 25(4):225-31. DOI: 10.1053/j.sempedsurg.2016.05.005. View

Di Serafino M, Esposito F, Mercogliano C, Vallone G . The triangular cord sign. Abdom Radiol (NY). 2016; 41(9):1867-8. DOI: 10.1007/s00261-016-0734-7. View

Nicotra J, Kramer S, Bellah R, Redd D . Congenital and acquired biliary disorders in children. Semin Roentgenol. 1997; 32(3):215-27. DOI: 10.1016/s0037-198x(97)80008-9. View

10.

Di Serafino M, Vitale V, Severino R, Barbuto L, Vezzali N, Ferro F . Pediatric ultrasonography of the pancreas: normal and abnormal findings. J Ultrasound. 2018; 22(3):261-272. PMC: 6704208. DOI: 10.1007/s40477-018-0348-8. View

11.

Valayer J . Conventional treatment of biliary atresia: long-term results. J Pediatr Surg. 1996; 31(11):1546-51. DOI: 10.1016/s0022-3468(96)90174-8. View

12.

Liu B, Cai J, Xu Y, Peng X, Zheng H, Huang K . Three-dimensional magnetic resonance cholangiopancreatography for the diagnosis of biliary atresia in infants and neonates. PLoS One. 2014; 9(2):e88268. PMC: 3914942. DOI: 10.1371/journal.pone.0088268. View

13.

Kanegawa K, Akasaka Y, Kitamura E, Nishiyama S, Muraji T, Nishijima E . Sonographic diagnosis of biliary atresia in pediatric patients using the "triangular cord" sign versus gallbladder length and contraction. AJR Am J Roentgenol. 2003; 181(5):1387-90. DOI: 10.2214/ajr.181.5.1811387. View

14.

Park W, Choi S, Lee H . The ultrasonographic 'triangular cord' coupled with gallbladder images in the diagnostic prediction of biliary atresia from infantile intrahepatic cholestasis. J Pediatr Surg. 1999; 34(11):1706-10. DOI: 10.1016/s0022-3468(99)90650-4. View

15.

Choi S, Park W, Lee H, Woo S . 'Triangular cord': a sonographic finding applicable in the diagnosis of biliary atresia. J Pediatr Surg. 1996; 31(3):363-6. DOI: 10.1016/s0022-3468(96)90739-3. View

16.

Della Corte C, Falchetti D, Nebbia G, Calacoci M, Pastore M, Francavilla R . Management of cholelithiasis in Italian children: a national multicenter study. World J Gastroenterol. 2008; 14(9):1383-8. PMC: 2693686. DOI: 10.3748/wjg.14.1383. View

17.

Jeon J, Song S, Lee K, Lee K, Bae M, Lee J . Clinical significance and long-term outcome of incidentally found bile duct dilatation. Dig Dis Sci. 2013; 58(11):3293-9. DOI: 10.1007/s10620-013-2792-9. View

18.

Naji O, Hussain A, Baker D, Habib N, El-Hasani S . Obstructive jaundice due to autoimmune cholangiopathy. BMJ Case Rep. 2011; 2009. PMC: 3027632. DOI: 10.1136/bcr.11.2008.1291. View

19.

Bernard O, Brunelle F, Hadchouel M, POLONOVSKI C, Baudon J, Beguet P . Sclerosing cholangitis with neonatal onset. J Pediatr. 1987; 111(2):225-9. DOI: 10.1016/s0022-3476(87)80072-0. View

20.

Oppong K, Mitra V, Scott J, Anderson K, Charnley R, Bonnington S . Endoscopic ultrasound in patients with normal liver blood tests and unexplained dilatation of common bile duct and or pancreatic duct. Scand J Gastroenterol. 2014; 49(4):473-80. DOI: 10.3109/00365521.2014.881547. View