Document Detail


US approach to jaundice in infants and children.
MedLine Citation:
PMID:  10682780     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
High-resolution real-time ultrasonography (US) serves as an important tool for differentiation of obstructive and nonobstructive causes of jaundice in infants and children, independent of liver function. Unconjugated hyperbilirubinemia occurs in approximately 60% of normal term infants and in 80% of preterm infants. Persistence of neonatal jaundice beyond 2 weeks of age demands US evaluation to differentiate between the three most common causes: hepatitis, biliary atresia, and choledochal cyst. In all three conditions, the hepatic echotexture is diffusely coarse and hyperechoic, but this appearance may be seen in a variety of hepatic inflammatory, obstructive, and metabolic processes. Thus, hepatic scintigraphy and at times percutaneous liver biopsy are necessary to narrow the differential diagnosis and to identify patients who require more invasive techniques (eg, intraoperative cholangiography). US is useful for demonstrating inspissated bile and biliary duct stones. In infants, stones are usually secondary to obstructive congenital anomalies of the biliary tract, total parenteral nutrition, furosemide treatment, phototherapy, dehydration, infection, hemolytic anemia, and short-gut syndrome, whereas in older children, stones are usually associated with sickle cell disease, bowel resection, hemolytic anemia, and choledochal cyst. Jaundice in infants and children may also be due to cirrhosis, benign strictures, and neoplastic processes.
Authors:
J A Gubernick; H K Rosenberg; H Ilaslan; A Kessler
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Radiographics : a review publication of the Radiological Society of North America, Inc     Volume:  20     ISSN:  0271-5333     ISO Abbreviation:  Radiographics     Publication Date:    2000 Jan-Feb
Date Detail:
Created Date:  2000-03-03     Completed Date:  2000-03-03     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8302501     Medline TA:  Radiographics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  173-95     Citation Subset:  IM    
Affiliation:
Department of Radiology, Albert Einstein Medical Center, Philadelphia, PA 19141-3098, USA.
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MeSH Terms
Descriptor/Qualifier:
Biliary Atresia / complications,  ultrasonography
Child
Choledochal Cyst / complications,  ultrasonography
Cholelithiasis / complications,  ultrasonography
Diagnosis, Differential
Hepatitis / complications,  ultrasonography
Humans
Infant
Infant, Newborn
Jaundice / etiology,  ultrasonography*
Liver Cirrhosis / complications,  ultrasonography
Liver Neoplasms / complications,  ultrasonography
Reproducibility of Results
Ultrasonography, Doppler*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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