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Biliary Atresia

Chandler NCC - MedPix

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Affiliation: Tripler Army Medical Center

ABSTRACT

Diagnosis: Biliary Atresia

History: 3 month old infant with an elevated direct bilirubin level. The patient has been on phenobarbitol for one week.

Findings: Diffuse and homogeneous uptake is present in the liver without any focal defect. There was delayed clearance of blood pool activity with the heart visible at 40 minutes post infusion. There is significant excretion of activity by the kidneys and bladder. Images obtained at 4 hours demonstrate significant activity in the bladder as well as a lesser amount of uptake superior to the bladder, which likely represents motion artifact. No bowel activity is seen. The image obtained at 24 hours demonstrates continued radiotracer uptake in the liver and a small amount of activity in the bladder. Still, no bowel activity is seen.

Ddx: Persistent blood pool activity, prolonged radiotracer uptake in the liver, and radiotracer clearance by kidney and bladder, all are evidence of very poor hepatic function. Lack of secretion into the biliary system is consistent with high grade obtsruction such as biliary atresia. The differential diagnosis includes choledocolithiasis, obstructing neoplasm or proximal biliary stricture.

No MeSH data available.


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Biliary Atresia

Chandler NCC - MedPix

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1003&req=5

View Article: MedPix Image - MedPix Case

Affiliation: Tripler Army Medical Center

ABSTRACT

Diagnosis: Biliary Atresia

History: 3 month old infant with an elevated direct bilirubin level. The patient has been on phenobarbitol for one week.

Findings: Diffuse and homogeneous uptake is present in the liver without any focal defect. There was delayed clearance of blood pool activity with the heart visible at 40 minutes post infusion. There is significant excretion of activity by the kidneys and bladder. Images obtained at 4 hours demonstrate significant activity in the bladder as well as a lesser amount of uptake superior to the bladder, which likely represents motion artifact. No bowel activity is seen. The image obtained at 24 hours demonstrates continued radiotracer uptake in the liver and a small amount of activity in the bladder. Still, no bowel activity is seen.

Ddx: Persistent blood pool activity, prolonged radiotracer uptake in the liver, and radiotracer clearance by kidney and bladder, all are evidence of very poor hepatic function. Lack of secretion into the biliary system is consistent with high grade obtsruction such as biliary atresia. The differential diagnosis includes choledocolithiasis, obstructing neoplasm or proximal biliary stricture.

No MeSH data available.