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The diagnostic significance of cholescintigraphy and ultrasound examination in cholestatic syndromes in infancy

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Abstract

Thirty-three neonates and infants with cholestatic syndromes of various etiologies were evaluated by cholescintigraphy and ultrasound examinations. The results of these two diagnostic procedures were compared with the final diagnosis as confirmed by liver biopsy and/or laparotomy and the clinica follow-up of the infants. Fourteen patients had an obstructive cholangiopathy (11 biliary atresia, 2 choledochal cysts, 1 congenital choledochal stenosis), 13 had neonatal hepatitis, and 6 had cholestasis of another etiology. Typical ultrasonic and/or scintigraphic findings confirmed or excluded the need for surgical exploration in 28 patients. Thus, for must infants with cholestatic syndromes it is possible to differentiate the cause without invasive diagnostic techniques such as liver biopsy or exploratory laparotomy.

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References

  1. Abramson SJ, Treves S, Teele RL (1982) The infant with possible biliary atresia: evaluation by ultrasound and nuclear medicine. Pediatr Radiol 12: 1–5

    Google Scholar 

  2. Alvares F, Yvart J, Odiévre M (1981) The rose bengal test in neonatal cholestasis: diagnostic and prognostic value. Eur J Pediatr 137: 27–29

    Google Scholar 

  3. Bläker F (1981) Differentialdiagnose des Ikterus. In: Bachmann KD, Ewerbeck H (ed) Pädiatrie in Praxis und Klinik. Thieme, Stuttgart, pp 133–135

    Google Scholar 

  4. Collier BD, Treves S, Davies MA, Heyman S, Subramian G, McAffe JG (1980) Simultaneous 99m-P-Tc-butyl-IDA and 131 J-rose-bengal scintigraphy in neonatal jaundice. Radiology 134: 719–722

    Google Scholar 

  5. Cooper PL, Burhenne HJ (1981) Real-time-ultrasonography: diagnostic technique of choice in calculous gallbladder disease. N Engl J Med 302: 1277–1279

    Google Scholar 

  6. Dewbury KC (1979) Visualization of normal biliary ducts with ultrasound. Br J Radiol 53: 774–780

    Google Scholar 

  7. Eißner D, Hahn K, Baumann W, Peters H (1982) Hepatobiliäre Sequenz- und Funktionsscintigraphie in der Pädiatrie. Nuklearmediziner 5: 27–38

    Google Scholar 

  8. Feist D (1979) Pathogenese der neonatalen Cholestase-Syndrome. Leber Magen Darm 9: 43–46

    Google Scholar 

  9. Fried AM, Bell RM, Bibins BA (1981) Biliary obstruction in a canine model: sequential study of the sonographic threshold. Invest Radiol 16: 317–319

    Google Scholar 

  10. Gates AF, Sinatra FR, Thomas DW (1980) Cholestatic syndromes in infancy and childhood. AJR: 1141–1148

  11. Hayden PW, Rudd TG, Christie DL (1979) Rose bengal sodium 131 studies in infants with suspected biliary atresia. AM J Dis Child 133: 834–837

    Google Scholar 

  12. Laing FC, London FA, Filly RA (1978) Ultrasonic identification of dilated intrahepatic bile ducts and their differentiation from portal vein structures. JCU 6: 90–94

    Google Scholar 

  13. Lilly R (1955) The Japanese operation for biliary atresia: remedy of mischief? Pediatrics 55: 12–19

    Google Scholar 

  14. Manginello FP, Javitt NB (1979) Parenteral nutrition and neonatal cholestasis. J Pediatr 94: 295–298

    Google Scholar 

  15. Medrano-Heredia J, Schmidt G, Hartmann W, Heckemann R, Eigler FW (1979) Zur Diagnostik und Behandlung von Choledochuszysten. Leber Magen Darm 9: 85–93

    Google Scholar 

  16. Miller SH, Sinatra DW, Thomas DW (1980) Biliary excretion disorders in infants: evaluation using 99mTc PIPDA. AJR 135: 47–52

    Google Scholar 

  17. Owmann T, Reichardt W, Reichardt W (1979) Perkutane transhepatische Diagnostik und Therapie beim Stauungsikterus. Radiologie 19: 375–384

    Google Scholar 

  18. Parulekar S (1979) Ultrasound evaluation of common bile duct size. Radiology 133: 703–707

    Google Scholar 

  19. Perez-Soler A (1976) The inflammatory and the atresia inducing disease of the liver and the bile ducts. Monogr Pediatr 8: 20

    Google Scholar 

  20. Perlmutter GS, Goldberg BB (1976) Ultrasonic evaluation of the common bile duct. JCU 4: 107–111

    Google Scholar 

  21. Peters H, Dittrich M, Eißner D (1982) Ikterus. In: Weitzel D, Tröger J (eds) Morphologische Abdominaldiagnostik im Kindesalter. Springer, Berlin Heidelberg New York, pp 31–35

    Google Scholar 

  22. Peters H, Dittrich M, Dinkel E (1983) Sonograpische Diagnostik der Gallenwege im Kindesalter. Ultraschall Med 4: 147–153

    Google Scholar 

  23. Peters H, Baumann W, Dittrich M, Hofmann-v. Kap-herr S (1983) Association von Gallengangsatresien mit gastrointestinalen Fehlbildungen. In: Müller WD, Schober P (eds) Pädiatrische Intensivmedizin IV. Thieme, Stuttgart New York, pp 271–276

    Google Scholar 

  24. Peters H, Baumann W, Hahn K, Dittrich M, Rauber M, Loos L (1983) High resolution ultrasonography of the normal and the dilated biliary tract in neonates and young pigs: 28th Annual Convention of the American Institute of Ultrasound in Medicine, 18–21 Oct 1983, New York. J Ultrasound Med 2: 141

    Google Scholar 

  25. Piyachon CH, Poshychinda M, Dhitavat V (1976) Hepatoscintigraphy, arteriography and ultrasonography in preoperative diagnosis of choledochal cysts. AJR 127: 520–523

    Google Scholar 

  26. Poley JR (1979) Differentialdiagnose zwischen Gallengangsatresie und idiopathischer neonataler Hepatitis. Monatsschr Kinderheilkunde 127: 604–606

    Google Scholar 

  27. Rager R, Finegold MJ (1975) Cholestasis in immature newborn infants: is parenteral alimentation responsible? Pediatrics 86: 264–269

    Google Scholar 

  28. Rickham PP, Hirsig J (1979) Biliary atresia: recent advances in etiology, diagnosis and treatment. Z Kinderchir 26: 114–122

    Google Scholar 

  29. Sharp HL, Krivit Q, Lowmann JT (1967) The diagnosis of complete extrahepatic obstruction by rose bengal. J Pediatr 70: 46–53

    Google Scholar 

  30. Shawker TH, Jones BL, Girton ME (1981) Distal common bile duct obstruction: an experimental study in monkeys. JCU 9: 77–82

    Google Scholar 

  31. Thaler M, Gellis S (1968) Studies in neonatal hepatitis and biliary atresia. Am J Dis Child 116: 257–284

    Google Scholar 

  32. Touloukian RJ, Seashore JH (1975) Hepatic secretory obstruction with total parenteral nutrition in the infant. J Pediatr Surg 10: 353–360

    Article  CAS  PubMed  Google Scholar 

  33. Weitzel D, Beck JD (1974) Ultraschalltomographie: eine risikolose und schonende Methode zum Nachweis der angeborenen Choledochuszyste. Klin Pädiatr 186: 460–464

    Google Scholar 

  34. Yeung CY (1972) Serum 5′-nucleotidase in neonatal hepatitis and biliary atresia: preliminary observation. Pediatrics 50: 812–820

    Google Scholar 

  35. Zelter PM, Fonkalsrud RC, Nerhout RC, Stiehin ER (1974) Differentiation between neonatal hepatitis and biliary atresia by measuring serum alpha-fetoprotein. Lancet 1: 373

    Google Scholar 

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Authors and Affiliations

  1. Kinderklinik der Johannes Gutenberg-Universität, D-6500, Mainz, Federal Republic of Germany

    H. Peters, K. Hahn & W. Baumann

  2. Institut für klinische Strahlenkunde der Johannes-Gutenberg-Universität, D-6500, Mainz, Federal Republic of Germany

    D. Eißner

  3. Kinderabteilung des Paulinenstiftes, D-6200, Wiesbaden, Federal Republic of Germany

    D. Weitzel

  4. Zentrum Radiologie, Abteilung Röntgendiagnostik der Universität, D-7800, Freiburg, Federal Republic of Germany

    E. Dinkel

  5. Klinik und Poliklinik für Kinderchirurgie der Johannes-Gutenberg-Universität, D-6500, Mainz, Federal Republic of Germany

    S. Hofmann-v. Kap-herr

Authors
  1. H. Peters
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  2. D. Eißner
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  3. D. Weitzel
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  4. E. Dinkel
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  5. K. Hahn
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  6. W. Baumann
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  7. S. Hofmann-v. Kap-herr
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Peters, H., Eißner, D., Weitzel, D. et al. The diagnostic significance of cholescintigraphy and ultrasound examination in cholestatic syndromes in infancy. Pediatr Surg Int 3, 37–42 (1988). https://doi.org/10.1007/BF00177078

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