Findings in percutaneous trans-hepatic cholecysto-cholangiography in neonates and infants presenting with conjugated hyperbilirubinemia: emphasis on differential diagnosis and cholangiographic patterns
Abstract Background Biliary atresia (BA) is one of the causes of conjugated hyperbilirubinemia in infants which if untreated leads to end-stage liver disease and death. Percutaneous Trans-hepatic Cholecysto-Cholangiography (PTCC) is a minimally invasive study which can be utilized in the diagnostic...
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-022-03816-y |
| _version_ | 1797952376079908864 |
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| author | Dimitri A. Parra Shannon E. Peters Ruhail Kohli Racha Chamlati Bairbre L. Connolly Justyna M. Wolinska Vicky L. Ng Michael J. Temple Philip R. John Binita M. Kamath Simon C. Ling Annie Fecteau Afsaneh Amirabadi Joao G. Amaral |
| author_facet | Dimitri A. Parra Shannon E. Peters Ruhail Kohli Racha Chamlati Bairbre L. Connolly Justyna M. Wolinska Vicky L. Ng Michael J. Temple Philip R. John Binita M. Kamath Simon C. Ling Annie Fecteau Afsaneh Amirabadi Joao G. Amaral |
| author_sort | Dimitri A. Parra |
| collection | DOAJ |
| description | Abstract Background Biliary atresia (BA) is one of the causes of conjugated hyperbilirubinemia in infants which if untreated leads to end-stage liver disease and death. Percutaneous Trans-hepatic Cholecysto-Cholangiography (PTCC) is a minimally invasive study which can be utilized in the diagnostic work-up of these patients. This study’s purpose is to describe the experience with PTCC in neonates, the imaging findings encountered, and the abnormal patterns which warrant further investigation. Methods A 16-year single-center retrospective study of patients with persistent neonatal cholestasis (suspected BA) undergoing PTCC. Patient demographics, laboratory values, PTCC images, pathology and surgical reports were reviewed. Results 73 patients underwent PTCC (68% male, mean age 8.7 weeks, mean weight 4.0 Kg). The majority of studies were normal (55%). Abnormal patterns were identified in 33 cases, 79% were diagnosed with BA and 12% with Alagille syndrome. Non-opacification of the common hepatic duct with a narrowed common bile duct (42%) and isolated small gallbladder (38%) were the most common patterns in BA. Conclusion PTCC is a minimally invasive study in the diagnostic work-up of infants presenting with conjugated hyperbilirubinemia (suspected BA). Further invasive investigations or surgery can be avoided when results are normal. |
| first_indexed | 2024-04-10T22:45:21Z |
| format | Article |
| id | doaj.art-d1881a92beaf46e1831a5dd15992cd97 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-04-10T22:45:21Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-d1881a92beaf46e1831a5dd15992cd972023-01-15T12:21:44ZengBMCBMC Pediatrics1471-24312023-01-0123111110.1186/s12887-022-03816-yFindings in percutaneous trans-hepatic cholecysto-cholangiography in neonates and infants presenting with conjugated hyperbilirubinemia: emphasis on differential diagnosis and cholangiographic patternsDimitri A. Parra0Shannon E. Peters1Ruhail Kohli2Racha Chamlati3Bairbre L. Connolly4Justyna M. Wolinska5Vicky L. Ng6Michael J. Temple7Philip R. John8Binita M. Kamath9Simon C. Ling10Annie Fecteau11Afsaneh Amirabadi12Joao G. Amaral13Division of Image Guided therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of TorontoDepartment of Family & Community Medicine, University of TorontoDivision of Gastroenterology and Hepatology, Johns Hopkins University School of MedicineDepartment of Psychiatry, St. Elizabeth’s Medical CenterDivision of Image Guided therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of TorontoDivision of Pediatric Surgery, Children’s Hospital of Eastern Ontario (CHEO)Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, University of TorontoDivision of Image Guided therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of TorontoDivision of Image Guided therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of TorontoDivision of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, University of TorontoDivision of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, University of TorontoDivision of General and Thoracic Surgery, The Hospital for Sick Children, University of TorontoDivision of Image Guided therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of TorontoDivision of Image Guided therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of TorontoAbstract Background Biliary atresia (BA) is one of the causes of conjugated hyperbilirubinemia in infants which if untreated leads to end-stage liver disease and death. Percutaneous Trans-hepatic Cholecysto-Cholangiography (PTCC) is a minimally invasive study which can be utilized in the diagnostic work-up of these patients. This study’s purpose is to describe the experience with PTCC in neonates, the imaging findings encountered, and the abnormal patterns which warrant further investigation. Methods A 16-year single-center retrospective study of patients with persistent neonatal cholestasis (suspected BA) undergoing PTCC. Patient demographics, laboratory values, PTCC images, pathology and surgical reports were reviewed. Results 73 patients underwent PTCC (68% male, mean age 8.7 weeks, mean weight 4.0 Kg). The majority of studies were normal (55%). Abnormal patterns were identified in 33 cases, 79% were diagnosed with BA and 12% with Alagille syndrome. Non-opacification of the common hepatic duct with a narrowed common bile duct (42%) and isolated small gallbladder (38%) were the most common patterns in BA. Conclusion PTCC is a minimally invasive study in the diagnostic work-up of infants presenting with conjugated hyperbilirubinemia (suspected BA). Further invasive investigations or surgery can be avoided when results are normal.https://doi.org/10.1186/s12887-022-03816-yBiliary atresiaPTCCPediatric cholangiographyConjugated hyperbilirubinemia, Alagille’s syndrome |
| spellingShingle | Dimitri A. Parra Shannon E. Peters Ruhail Kohli Racha Chamlati Bairbre L. Connolly Justyna M. Wolinska Vicky L. Ng Michael J. Temple Philip R. John Binita M. Kamath Simon C. Ling Annie Fecteau Afsaneh Amirabadi Joao G. Amaral Findings in percutaneous trans-hepatic cholecysto-cholangiography in neonates and infants presenting with conjugated hyperbilirubinemia: emphasis on differential diagnosis and cholangiographic patterns BMC Pediatrics Biliary atresia PTCC Pediatric cholangiography Conjugated hyperbilirubinemia, Alagille’s syndrome |
| title | Findings in percutaneous trans-hepatic cholecysto-cholangiography in neonates and infants presenting with conjugated hyperbilirubinemia: emphasis on differential diagnosis and cholangiographic patterns |
| title_full | Findings in percutaneous trans-hepatic cholecysto-cholangiography in neonates and infants presenting with conjugated hyperbilirubinemia: emphasis on differential diagnosis and cholangiographic patterns |
| title_fullStr | Findings in percutaneous trans-hepatic cholecysto-cholangiography in neonates and infants presenting with conjugated hyperbilirubinemia: emphasis on differential diagnosis and cholangiographic patterns |
| title_full_unstemmed | Findings in percutaneous trans-hepatic cholecysto-cholangiography in neonates and infants presenting with conjugated hyperbilirubinemia: emphasis on differential diagnosis and cholangiographic patterns |
| title_short | Findings in percutaneous trans-hepatic cholecysto-cholangiography in neonates and infants presenting with conjugated hyperbilirubinemia: emphasis on differential diagnosis and cholangiographic patterns |
| title_sort | findings in percutaneous trans hepatic cholecysto cholangiography in neonates and infants presenting with conjugated hyperbilirubinemia emphasis on differential diagnosis and cholangiographic patterns |
| topic | Biliary atresia PTCC Pediatric cholangiography Conjugated hyperbilirubinemia, Alagille’s syndrome |
| url | https://doi.org/10.1186/s12887-022-03816-y |
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