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Lin Q, Liang C, Du B, Li L, Li H, Mai X, Li S, Xu W, Wu C, Zeng M. Prenatal detection and molecular cytogenetic characterization of Xp deletion and Xq duplication: a case report and literature review. BMC Med Genomics 2024; 17:57. [PMID: 38383389 PMCID: PMC10880359 DOI: 10.1186/s12920-024-01824-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/06/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Copy number variation (CNV) of X chromosome can lead to a variety of neonatal abnormalities, especially for male fetuses. In recent years, due to the high sensitivity and high specificity of NIPS, its application has gradually expanded from chromosome aneuploidy to CNV. Few prenatal cases involving the detection of Xq duplication and deletion by NIPS have been reported, but it is of great significance for genetic counseling. CASE PRESENTATION A 36-year-old woman was referred for prenatal diagnosis and genetic counseling at 17 weeks of gestation because of abnormal result of noninvasive prenatal screening (NIPS). Multiple congenital malformations, hydrocephalus, and enlarged gallbladder were observed by prenatal ultrasound. Amniocentesis revealed the karyotype of the fetus as 46, XN, add(X) (p22.2) and the result of chromosomal microarray analysis was arr[hg19] Xq27.1q28(138,506,454-154896094) × 2 and arr[hg19] Xp22.33p22.32(168,551-5,616,964) × 1. CNV-seq showed that the mother shares a 16.42 Mb duplication in the Xq27.1-q28 region and a 2.97 Mb deletion in the Xp22.33-p22.32 region. After genetic counseling, the couple chose to terminate the pregnancy. CONCLUSION The combination of NIPS and CMA would be of values in detection of subchromosomal duplications and/or deletions at fetal stage. The detection of X chromosome aberration in a male fetus should give suspicion of the possibility of maternal inheritance.
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Affiliation(s)
- Qing Lin
- Center of Prenatal Diagnosis, Zhanjiang Maternity and Child Health Care Hospital, Zhanjiang, China.
| | - Chunya Liang
- Center of Prenatal Diagnosis, Zhanjiang Maternity and Child Health Care Hospital, Zhanjiang, China
| | - Bole Du
- Guangzhou Jingke Biotechnology Co., Ltd, Guangzhou, P. R. China
| | - Lijiao Li
- Center of Prenatal Diagnosis, Zhanjiang Maternity and Child Health Care Hospital, Zhanjiang, China
| | - Hong Li
- Guangzhou Jingke Biotechnology Co., Ltd, Guangzhou, P. R. China
| | - Xiaolan Mai
- Center of Prenatal Diagnosis, Zhanjiang Maternity and Child Health Care Hospital, Zhanjiang, China
| | - Sheng Li
- Guangzhou Jingke Biotechnology Co., Ltd, Guangzhou, P. R. China
| | - Wenyu Xu
- Center of Prenatal Diagnosis, Zhanjiang Maternity and Child Health Care Hospital, Zhanjiang, China
| | - Cunzhen Wu
- Center of Prenatal Diagnosis, Zhanjiang Maternity and Child Health Care Hospital, Zhanjiang, China
| | - Mi Zeng
- Guangzhou Jingke Biotechnology Co., Ltd, Guangzhou, P. R. China
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Boitor-Borza D, Rotar IC, Staicu A, Constantin R, Muresan D. Echogenic Content in the Fetal Gallbladder: Systematic Review of Ultrasound Features and Clinical Outcome. Diagnostics (Basel) 2023; 13:diagnostics13020230. [PMID: 36673040 PMCID: PMC9857929 DOI: 10.3390/diagnostics13020230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/10/2023] Open
Abstract
It is rare to detect echogenic content in the fetal gallbladder. The etiology, natural course, and prognosis of this condition remain unclear. In addition to providing a systematic review of this topic, we suggest a plan for patient follow-up. From a total of 100 database entries identified in PubMed, EMBASE, and ICTRP reviews, we selected 34 studies in which we investigated the ultrasound features and outcome of this condition. There were 226 fetuses with gallbladder echogenic content identified. Seventy-two fetuses were found to have biliary sludge; thirty cases had a single hyperechogenic focus, and one hundred fetuses had multiple foci in the gallbladder. There were 16 cases of distal shadowing, 37 fetuses with comet tail and twinkling, and 26 cases with no acoustic artifacts. Nine cases of spontaneous resolution before birth have been documented; nine fetuses exhibited no echogenic content at birth, and 138 cases of resolution of echogenic content within the first year of life have been described. Typically, the condition resolves spontaneously during the postnatal period. After adequately reassuring the parents, the patients should be monitored for spontaneous resolution; medical or surgical intervention is not indicated. Asymptomatic patients can be managed with a wait-and-see strategy.
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Affiliation(s)
- Dan Boitor-Borza
- Department of Obstetrics and Gynecology, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- 1st Department of Obstetrics and Gynecology, Emergency County Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Ioana Cristina Rotar
- Department of Obstetrics and Gynecology, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- 1st Department of Obstetrics and Gynecology, Emergency County Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Adelina Staicu
- Department of Obstetrics and Gynecology, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- 1st Department of Obstetrics and Gynecology, Emergency County Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Roxana Constantin
- 1st Department of Obstetrics and Gynecology, Emergency County Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Daniel Muresan
- Department of Obstetrics and Gynecology, "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- 1st Department of Obstetrics and Gynecology, Emergency County Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania
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Tonni G, Ruano R. Fetal cholelithiasis: What we know to counsel parents? J Clin Ultrasound 2022; 50:80-81. [PMID: 35043441 DOI: 10.1002/jcu.23109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Gabriele Tonni
- Department of Obstetrics and Neonatology, Prenatal Diagnosis Center & Researcher, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), AUSL di Reggio Emilia, Reggio Emilia, Italy
| | - Rodrigo Ruano
- Division of Maternal-Fetal, Department of Obstetrics, Gynecology and Reproductive Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Drakonaki E, Kokkinakis S, Karageorgiou I, Maliotis N, Ioannidoy A, Symvoulakis EK. A case of incidental infantile gallbladder adenomyomatosis: an unusual US finding of uncertain clinical significance. J Ultrason 2021; 20:e318-e321. [PMID: 33500801 PMCID: PMC7830060 DOI: 10.15557/jou.2020.0055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/18/2020] [Indexed: 12/18/2022] Open
Abstract
Adenomyomatosis of the gallbladder is defined as hypertrophy of the gallbladder mucosal epithelium that invaginates into a thickened muscularis propria, leading to the formation of intramural diverticula. It is typically considered a benign condition most commonly affecting adults and, rarely, children. In this case report, we present a case of gallbladder adenomyomatosis in a 3-month-old infant. The diagnosis was made incidentally on ultrasound examination of the abdomen, in an otherwise asymptomatic child with no laboratory test abnormalities and no underlying disease. The purpose of this case report is to make infantile adenomyomatosis and its implications known to clinicians, as the literature on this topic is limited. To the best of our knowledge, this is the youngest reported case of adenomyomatosis in the pediatric population.
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Affiliation(s)
- Elena Drakonaki
- Consultant Radiologist, Department of Anatomy, European University of Cyprus Medical School, Nicosia, Cyprus
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Abstract
Diseases of the gallbladder and biliary tract are extremely common in developed nations. Because of the physiology of pregnancy, their incidence increases during gestation. This article represents a review of the existing literature on the entire spectrum of biliary disease. The physiology, clinical presentation, and diagnostic evaluation of a variety of conditions are reviewed. Historical and contemporary data regarding pregnancy implications and treatment options are discussed.
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Sepulveda W, Wong AE. Echogenic material in the fetal gallbladder: prevalence, sonographic spectrum, and perinatal outcome in an unselected third-trimester population. J Matern Fetal Neonatal Med 2018; 33:1162-1170. [PMID: 30157688 DOI: 10.1080/14767058.2018.1517310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: To determine the prevalence, sonographic spectrum, and clinical significance of echogenic material in the fetal gallbladder in our population.Methods: Sonographic visualization of the fetal gallbladder was attempted in 3894 consecutive third-trimester pregnancies (4026 fetuses). Gallbladder content was classified as clear (anechoic), containing echogenic material that was either diffuse (sludge), or presenting as a single focus or multiple foci (gallstone(s)). Information on the clinical course was obtained by reviewing the medical records or contacting the provider or the parents themselves.Results: During the three and a half-year study period from July 2014 to December 2017, 19 fetuses were identified as having echogenic material in the gallbladder (prevalence 1/211, 0.47%). Among them, echogenic biliary sludge was found in eight fetuses (42%); all eight were asymptomatic and a normal gallbladder was documented postnatally in four of them. Single (n = 3) or multiple (n = 8) echogenic foci were found in 58% of cases, which was associated with a good prognosis and subsequent resolution between 1 and 10 months of life in all cases.Conclusions: The prevalence of echogenic material in the fetal gallbladder in our population was similar to that previously reported in the literature. The prognosis appears to be favorable, with resolution and without subsequent postnatal hepatic or gastrointestinal complications in all cases.
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Affiliation(s)
- Waldo Sepulveda
- FETALMED-Maternal-Fetal Diagnostic Center, Fetal Imaging Unit, Santiago, Chile
| | - Amy E Wong
- Department of Maternal Fetal Medicine, Palo Alto Medical Foundation, Mountain View, California, USA
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Kesrouani A, Nassif N, Nasr B, Choueiry E, Chalouhi G. Ultrasound characteristics and outcome of prenatally diagnosed fetal cholelithiasis. J Matern Fetal Neonatal Med 2018; 32:2095-2099. [PMID: 29301452 DOI: 10.1080/14767058.2018.1424819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM To investigate ultrasound characteristics and outcome in fetuses with cholelithiasis. MATERIALS AND METHODS We report a small case series of three patients with prenatally diagnosed fetal cholelithiasis. Ultrasound features, pregnancy outcome and neonatal follow-up are presented and discussed. RESULTS Sonographic pattern associated to fetal cholelithiasis is variable. Pregnancy issue is globally good with no ominous fetal or neonatal events. CONCLUSIONS Prenatally diagnosed fetal cholelithiasis is a rare finding and doesn't seem to carry an adverse effect on the pregnancy.
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Affiliation(s)
- Assaad Kesrouani
- a Department of Obstetrics and Gynaecology , St. Joseph University , Beirut , Lebanon
| | - Nadine Nassif
- a Department of Obstetrics and Gynaecology , St. Joseph University , Beirut , Lebanon
| | | | - Elie Choueiry
- c Department of Pediatrics , St. Joseph University , Beirut , Lebanon
| | - Gihad Chalouhi
- d Department of Obstetrics and Fetal Medicine , Fetal Medicine Unit, Necker-Enfants Malades Hospital, Université Paris Descartes , Sorbonne Paris Cité , Paris , France
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Hurni Y, Vigo F, von Wattenwyl BL, Ochsenbein N, Canonica C. Fetal Cholelithiasis: Antenatal Diagnosis and Neonatal Follow-Up in a Case of Twin Pregnancy - A Case Report and Review of the Literature. Ultrasound Int Open 2017; 3:E8-E12. [PMID: 28210714 DOI: 10.1055/s-0042-123840] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Fetal cholelithiasis is a rare finding during a third-trimester ultrasound with an average incidence rate of 0.07-1.15%. We report a case of fetal cholelithiasis in twins, observed in a patient with monochorionic diamniotic twin pregnancy hospitalized at our unit for signs of premature labor. We present the outcome of the 2 neonates with a clinical and sonographic follow-up. In addition, we offer a comprehensive review of the literature available to date.
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Affiliation(s)
- Yannick Hurni
- Obstetrics and Gynecology, Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland
| | - Francesco Vigo
- Obstetrics and Gynecology, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
| | | | - Nicole Ochsenbein
- Department of Obstetrics, University Hospital Zurich, Zürich, Switzerland
| | - Claudia Canonica
- Obstetrics and Gynecology, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
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Yon DK, An JW, Kim JH, Jeon JH, Heo JS. A Case of Fetal Cholelithiasis Related to Maternal Intrahepatic Cholestasis of Pregnancy. Neonatal Med 2017. [DOI: 10.5385/nm.2017.24.2.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Dong Keon Yon
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Jae Woo An
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ji Hee Kim
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ji-Hyun Jeon
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Ju Sun Heo
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
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Abstract
In a study of 113 routine transabdominal fetal OB exams with estimated gestational age ranging from 14 to 38 weeks, the fetal gallbladder was identified in 93.8% of the examinations. Fetal gallbladder size, shape, and pathologies associated with nonvisualization are discussed.
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Affiliation(s)
- Karen Having
- Southern Illinois University, Carbondale, Illinois; College of Applied Sciences and Arts, Mailcode 6615, Southern Illinois University, Carbondale, IL 62901
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11
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Abstract
The fetal gallbladder can be visualized on most sonographic screening examinations. After obtaining the abdominal circumference images, angling the transducer caudal along the anterior abdominal wall to the level of the umbilical cord insertion will generally bring the gallbladder into view to the right of the umbilical vein. Fetal cholelithiasis and/or sludge in the gallbladder is an uncommon sonographic finding characterized by echogenic material that may or may not produce shadowing. The likelihood of this occurrence is most prevalent in the third trimester of pregnancy. In most cases, fetal gallstones/sludge undergo spontaneous resolution within weeks or months after birth. Most investigators believe that the presence of fetal cholelithiasis or sludge does not alter fetal prognosis or obstetrical management. The finding of an echogenic mass in the abdominal region of the fetal gallbladder should prompt the sonographer to consider sludge and/or gallstones, albeit uncommon, as a possible explanation.
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Affiliation(s)
| | - Karen Having
- School of Allied Health, College of Applied Sciences and Arts, Southern Illinois University, Carbondale; College of Applied Sciences and Arts, Mailcode 6615, Southern Illinois University, Carbondale, IL 62901
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Thounaojam K, Wahengbam S, Singh NS, Singh YI. The gallbladder of human foetuses: A morphological and morphometric study. J ANAT SOC INDIA 2014. [DOI: 10.1016/j.jasi.2014.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Abstract
Fetal gallstones and cholelithiasis, detected by routine third trimester ultrasound, have been described in the literature with controversial clinical significance. We report a case of fetal cholelithiasis detected at 35 weeks gestation during a routine scan. The diagnosis was performed using an integrated 2-dimensional (2-D) and 3-dimensional (3-D) ultrasound approach in order to obtain a better definition of the fetal gallbladder and its content. A neonatal follow-up was achieved. The present study has a twofold purpose: firstly, to update the diagnostic approach using the innovative 3-D modalities and secondly, to review the management of this condition during fetal and postnatal life.
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Affiliation(s)
- Stefania Triunfo
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Paolo Rosati
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Pietro Ferrara
- Institute of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy
- Campus Bio-Medico University, Rome, Italy
| | - Antonio Gatto
- Institute of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy
| | - Giovanni Scambia
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
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Abstract
Gallstone disease in children is evolving, and for the previous 3 decades, the frequency for surgery has increased greatly. This is in part because of improved diagnostic modalities, but also changing pathology, an increased awareness of emerging comorbidities, such as childhood obesity, and other associated risk factors. This article outlines the pathophysiology, genetics, and predisposing factors for developing gallstones and includes a review of the literature on the current and more novel medical and surgical techniques to treat this interesting disease.
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Affiliation(s)
- Jan Svensson
- Department of Paediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital & Karolinska Institutet, Stockholm, Sweden
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Abstract
Intraabdominal calcifications and other echogenic masses are relatively common findings during fetal sonography. Many are associated with no additional risk for the fetus or neonate. They may arise from the liver, gallbladder, spleen, kidneys, adrenal glands, gastrointestinal tract, or peritoneal cavity. Detection of such lesions should prompt a detailed survey for additional findings and a review of the maternal history. In some cases, fetal karyotyping may be indicated. In most cases, the diagnosis, management, and outcome are determined according to a combination of specific ultrasound appearances and at least one additional maternal or fetal factor. In utero diagnosis can often be achieved with careful evaluation of the lesion echotexture, associated calcifications, additional findings, and evolution over time. In most cases, expectant management is sufficient, but some patients require transfer to a facility where early postnatal intervention is available. A systematic approach to the findings aids in differential diagnosis and management.
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Affiliation(s)
- Ann McNamara
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA
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Stewart L. The role of ultrasound in the investigation of childhood abdominal pain. Imaging 2004. [DOI: 10.1259/imaging/64124181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
The diagnosis and detection of some forms of liver and bile duct disease have become possible since the adoption of routine fetal ultrasound scanning in the UK, and the remarkable advances in molecular biological techniques. Nevertheless, although antenatal detection may well have improved, it remains difficult to offer a specific diagnosis, much less a prognosis, in most cases. Cystic dilatation of the biliary tree is probably the most common finding. This may be due to cystic choledochal malformations or, occasionally but crucially, biliary atresia. Postnatal investigations (such as ultrasonography, magnetic resonance cholangiography and liver histology) must take the latter possibility into account, as early surgery is the key to a successful outcome following reconstructive biliary surgery. Antenatally diagnosed liver tumours are usually of vascular origin and have an unpredictable natural history. Some may cause fetal cardiac failure and are candidates for in-utero intervention, but in all likelihood, a large proportion will resolve without specific therapy.
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Affiliation(s)
- Mark Davenport
- Department of Paediatric Surgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
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Managoli S, Chaturvedi P, Vilhekar KY, Pathak S. Gall bladder distention in a neonate. Indian J Pediatr 2003; 70:761-2. [PMID: 14620196 DOI: 10.1007/bf02724323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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