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Chapter 41

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1. GB duplication

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Figure 41-1

GB duplication.

A transverse sonographic image of a 3-week-old infant shows 2 distinct GBs (arrows).

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2. Biliary atresia: sonography

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Figure 41-2

Biliary atresia: sonography.

There are no sonographically visible bile ducts or gallbladder in this jaundiced 2-month-old infant.

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3. Biliary atresia: cholangiography

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Figure 41-3

Biliary atresia: cholangiography.

A percutaneous cholecystogram of a jaundiced 1-month-old infant shows filling of a small GB and a thin common bile duct, but no opacification of the common hepatic duct or intrahepatic ducts.

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4. Biliary atresia: scintigraphy

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Figure 41-4

Biliary atresia: scintigraphy.

A. A time-activity curve for regions of interest over the heart and liver show prompt hepatic uptake of injected radiopharmaceutical and prompt clearance from the cardiac blood pool. B. There is no bowel activity on an image obtained at 24 hours.

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5. Diagnostic cholangiography for infantile jaundice

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Figure 41-5

Diagnostic cholangiography for infantile jaundice.

A. Sonography of this 4-month-old infant shows a collapsed GB (arrows) despite appropriate NPO preparation. B. There is no visible hepatic excretion of radiopharmaceutical into the bowel on anterior and posterior delayed biliary scintigraphy images. C. Percutaneous cholangiography confirms patency of the extrahepatic and intrahepatic ducts, thereby excluding biliary atresia.

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6. Type III CC

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Figure 41-6

Type III CC.

There a smooth round filling defect in the duodenum at the expected location of the ampulla.

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7. Type I CC

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Figure 41-7

Type I CC.

A longitudinal sonographic image of a 2-day-old asymptomatic infant shows a large cyst (arrows) extending from the inferior aspect of the liver. A normal GB is located anterior to the lesion.

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8. Type I CC

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Figure 41-8

Type I CC.

A. Sonography of a 16-month-old child shows a cyst (arrow) in the porta hepatis region. The GB is normal. B, C. Contrast-enhanced CT confirms the presence of a cyst (arrow) that extends from the porta hepatis into the head of the pancreas. There is no separately visible common bile duct.

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