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Diagnostic Significance of Absence of Post-Feeding Contraction of the Gallbladder in Biliary Atresia: Two Case Reports

Ultrasonography is an essential part of the diagnostic process of biliary atresia (BA). The characteristic findings of BA include a hilar hyperechoic zone, the triangular cord sign (TCS), an absence of gallbladder contraction after feeding, and gallbladder atrophy. However, approximately 10% of pati...

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Autores principales: Kosuga, Masahiko, Fujii, Yoshimitsu, Doi, Takashi, Kaneko, Kazunari, Breugelmans, Raoul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537712/
https://www.ncbi.nlm.nih.gov/pubmed/37755409
http://dx.doi.org/10.3390/pediatric15030049
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author Kosuga, Masahiko
Fujii, Yoshimitsu
Doi, Takashi
Kaneko, Kazunari
Breugelmans, Raoul
author_facet Kosuga, Masahiko
Fujii, Yoshimitsu
Doi, Takashi
Kaneko, Kazunari
Breugelmans, Raoul
author_sort Kosuga, Masahiko
collection PubMed
description Ultrasonography is an essential part of the diagnostic process of biliary atresia (BA). The characteristic findings of BA include a hilar hyperechoic zone, the triangular cord sign (TCS), an absence of gallbladder contraction after feeding, and gallbladder atrophy. However, approximately 10% of patients with BA have a normal gallbladder. We herein present two cases of BA with normal morphology of the gallbladder as shown by ultrasonography. In the first case, the patient was positive for the TCS, negative for gallbladder atrophy, and positive for contraction of the gallbladder after feeding; the final diagnosis was hilar obstructive BA complicated by pancreaticobiliary maljunction. In the second case, the patient was positive for the TCS, negative for gallbladder atrophy, and negative for contraction of the gallbladder after feeding; the patient also had common bile duct obstruction and stenosis of the hepatic duct in the hilar region. Based on these two cases, we conclude that gallbladder findings are not diagnostic for BA because in some types, the gallbladder may be normal in morphology and even have the capacity for contraction after feeding.
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spelling pubmed-105377122023-09-29 Diagnostic Significance of Absence of Post-Feeding Contraction of the Gallbladder in Biliary Atresia: Two Case Reports Kosuga, Masahiko Fujii, Yoshimitsu Doi, Takashi Kaneko, Kazunari Breugelmans, Raoul Pediatr Rep Case Report Ultrasonography is an essential part of the diagnostic process of biliary atresia (BA). The characteristic findings of BA include a hilar hyperechoic zone, the triangular cord sign (TCS), an absence of gallbladder contraction after feeding, and gallbladder atrophy. However, approximately 10% of patients with BA have a normal gallbladder. We herein present two cases of BA with normal morphology of the gallbladder as shown by ultrasonography. In the first case, the patient was positive for the TCS, negative for gallbladder atrophy, and positive for contraction of the gallbladder after feeding; the final diagnosis was hilar obstructive BA complicated by pancreaticobiliary maljunction. In the second case, the patient was positive for the TCS, negative for gallbladder atrophy, and negative for contraction of the gallbladder after feeding; the patient also had common bile duct obstruction and stenosis of the hepatic duct in the hilar region. Based on these two cases, we conclude that gallbladder findings are not diagnostic for BA because in some types, the gallbladder may be normal in morphology and even have the capacity for contraction after feeding. MDPI 2023-09-06 /pmc/articles/PMC10537712/ /pubmed/37755409 http://dx.doi.org/10.3390/pediatric15030049 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Kosuga, Masahiko
Fujii, Yoshimitsu
Doi, Takashi
Kaneko, Kazunari
Breugelmans, Raoul
Diagnostic Significance of Absence of Post-Feeding Contraction of the Gallbladder in Biliary Atresia: Two Case Reports
title Diagnostic Significance of Absence of Post-Feeding Contraction of the Gallbladder in Biliary Atresia: Two Case Reports
title_full Diagnostic Significance of Absence of Post-Feeding Contraction of the Gallbladder in Biliary Atresia: Two Case Reports
title_fullStr Diagnostic Significance of Absence of Post-Feeding Contraction of the Gallbladder in Biliary Atresia: Two Case Reports
title_full_unstemmed Diagnostic Significance of Absence of Post-Feeding Contraction of the Gallbladder in Biliary Atresia: Two Case Reports
title_short Diagnostic Significance of Absence of Post-Feeding Contraction of the Gallbladder in Biliary Atresia: Two Case Reports
title_sort diagnostic significance of absence of post-feeding contraction of the gallbladder in biliary atresia: two case reports
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537712/
https://www.ncbi.nlm.nih.gov/pubmed/37755409
http://dx.doi.org/10.3390/pediatric15030049
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