Pregnancy Outcomes of Non-Visualization of The Foetal Gallbladder From A Chinese Tertiary Single Centre And Literature Review

Objection To explore the clinical features and prognosis of non-visualization of fetal gallbladder (NVFGB). Methods 65 cases diagnosed of NVFGB in the Peking University First Hospital was collected retrospectively from January, 2019 to December, 2020. Results 49 cases were successfully followed up. Among them, the gallbladder of 21 fetuses (42.9%) was visible later, either in the later pregnancy or after birth. In the rest 28 cases (57.1%), the gallbladders were not seen during the whole pregnancy. 11 of 28 fetuses (39.3%) with NVFGB were complicated with other structure anomaly. In the remaining 17 cases of isolated NVFGB (60.7%), one case was diagnosed of congenital biliary atresia, 3 cases of small gallbladder, 1 case of gallstone and one case of irregular size of gallbladder. There are 9 cases who underwent prenatal diagnosis, with 4 cases of abnormal result. Conclusion Prenatal ultrasound plays a role in the early recognize of abnormal gallbladder, which will improve the postnatal prognosis.

Identifying the etiological profile of children presented with hepatomegaly admitted to a tertiary care hospital

Objectives: To identify the pattern and etiology of diseases in children presented hepatomegaly at Pediatrics Department in Hue Central Hospital, Vietnam. Material and Methods: The Present study was conducted to evaluate the possible etiology and clinical features of children presented with hepatomegaly. A total of 107 children, from one month to fifteen years of age with hepatomegaly admitted in the Pediatric Department of Hue Central Hospital, Vietnam from May 2018 to April 2019 were included in this study. Results: The most common causes of hepatomegaly were inflammation/infection of the liver (miscellaneous cause included), hematological diseases and congestion heart failure with the percentage of 50.5%; 27,1% and 12,1%; respectively. Among the hepatitis group, viral agents account for nearly 50.0%, of which the most common one was Cytomegalovirus accounting for nearly 30.0%. Distribution of causes by age group revealed most cases in 1 year-old or younger children was caused by inflammation (53.8%), and in the older than 1 year-old children were hematological disorders (47.3%) which has statistical significance (P<0.05). Conclusions: Our research observed that the most common causes of the group of ≤ 1 year old were hepatitis, followed by cardiovascular disease and biliary obstruction due to congenital biliary atresia, and in the older than 1 year group, hematological disorders was the most common.

Hepatic Hilar Lymph Node Reactivity at Kasai Portoenterostomy for Biliary Atresia: Correlations With Age, Outcome, and Histology of Proximal Biliary Remnant

We hypothesized that if infection is the proximate cause of congenital biliary atresia, an appropriate response to antigen would occur in lymph nodes contiguous with the biliary remnant. We compared the number of follicular germinal centers (GC) in 79 surgically excised hilar lymph nodes (LN) and 27 incidentally discovered cystic duct LNs in 84 subjects at the time of hepatic portoenterostomy (HPE) for biliary atresia (BA) to autopsy controls from the pancreaticobiliary region of non-septic infants >3 months old at death. All 27 control LN lacked GC, a sign in infants of a primary response to antigenic stimulation. GC were found in 53% of 106 LN in 56 of 84 subjects. Visible surgically excised LN contiguous with the most proximal biliary remnants had 1 or more well-formed reactive GC in only 26/51 subjects. Presence of GC and number of GC/LN was unrelated to age at onset of jaundice or to active fibroplasia in the biliary remnant but was related to older age at HPE. Absent GC in visible and incidentally removed cystic duct LNs predicted survival with the native liver at 2 and 3 years after HPE, P = .03, but significance was lost at longer intervals. The uncommon inflammatory lesions occasionally found in remnants could be secondary either to bile-induced injury or secondary infection established as obstruction evolves. The absence of consistent evidence of antigenic stimulation in LN contiguous with the biliary remnant supports existence of at least 1 major alternative to infection in the etiology of biliary atresia.