1/4. Spontaneous gallbladder perforation in a neonate.We describe the case of a 700-g neonate who presented with abdominal discolouration, distension, and rapid clinical deterioration. At laparotomy, a perforation in the neck of the gallbladder was found, which was simply over-seen. Perforation of the gallbladder should be considered in the differential diagnosis in such neonates. The surgical management should be direct repair, without resorting to a cholecystectomy.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/4. Serial ultrasonic examination to differentiate biliary atresia from neonatal hepatitis--special reference to changes in size of the gallbladder.We performed serial ultrasonic examinations to differentiate biliary atresia from neonatal hepatitis. The subjects studied were 144 children (100 normal neonates and infants, 31 patients with neonatal hepatitis and 13 patients with biliary atresia). They were examined by ultrasound before, during and after feeding. In 97 out of 100 normal children and all patients with neonatal hepatitis, the gallbladder was identified, and the change in size following oral feeding was observed. In four children with severe neonatal hepatitis which could not be differentiated from biliary atresia by clinical and laboratory data, we readily identified the gallbladder and observed the change in the size following oral feeding. In 8 of 13 patients with biliary atresia, we identified a small gallbladder whose size was not affected by oral feeding. In the other patients the gallbladder was not identified before, during or after oral feeding. On the basis of these results, we consider that serial ultrasonic examination with oral feeding aids in a differential diagnosis of biliary atresia and neonatal hepatitis.- - - - - - - - - - ranking = 1.3333333333333keywords = gallbladder (Clic here for more details about this article) |
3/4. Neonatal gallbladder enlargement and alpha 1-antitrypsin deficiency.patients with clinical signs of alpha 1-antitrypsin deficiency in the neonatal period usually present with prolonged obstructive jaundice. We report a patient with alpha 1-antitrypsin deficiency who presented with gallbladder enlargement in the neonatal period. This gallbladder enlargement may be due to cystic duct hypoplasia or atresia, which has been reported in association with alpha 1-antitrypsin deficiency. The diagnosis of alpha 1-antitrypsin deficiency should be considered in neonates with gallbladder enlargement and prolonged obstructive jaundice.- - - - - - - - - - ranking = 1.1666666666667keywords = gallbladder (Clic here for more details about this article) |
4/4. infant cholelithiasis: report of a case.cholelithiasis is an extremely unusual finding in infancy. The following article describes the case of a 2-month-old male with a VACTER association who presented with persistent and progressive obstructive jaundice and acholic stool due to cholelithiasis. Thirty cases under the age of 1, including our case, have previously been reported in the Japanese literature. Twenty-eight cases had predisposing factors. The calculi were present only in the gallbladder in 18 cases, in the common bile duct or cystic duct or both in 7 cases, and in the gallbladder and common bile duct in 3 cases. Ten cases of stones were radiopaque, which thus made the plain abdominal roentgenogram findings very valuable. Nine cases underwent operation including cholecystectomy in 3 cases, choledocholithotomy in 3 cases, and cholecystolithotomy in 1 case, while the procedure was unknown in 2 cases. Recently, the number of reported cases of cholelithiasis in infants has gradually increased and today these cases are most often diagnosed by ultrasonography, because the examination is easy to perform and not invasive.- - - - - - - - - - ranking = 0.33333333333333keywords = gallbladder (Clic here for more details about this article) |