gallstones
description
gallstones are extremely rare in the fetus and indeed the neonate. an incidence of about 1.5% is reported in paediatric populations. they may be associated with abnormalities of the biliary tree, haemolytic disease due to sickle cell disease, thalassaemia or spherocytosis.
diagnosis
the presence of echodense material within the gallbladder (sludge) can be clearly identified on the right side of the liver. gallstones in neonates and infants are associated with conditions such as sickle cell disease, thalassaemia and rhesus disease where there is significant haemolysis, as well as with cystic fibrosis, pancreatitis and the use of long-term hyperalimentation. however gallstones in fetuses are not thought to be associated with any underlying haematological or other condition.
differential diagnosis
other forms of diffuse ultrasonically-dense structures such as intraperitoneal calcification which occasionally becomes localised to the subdiaphragmatic areas, need to be differentiated. these calcifications are more common and likely to be the result of meconium peritonitis and/or bowel perforation.
sonographic features
echodense sludge within the gallbladder
there is no ultrasonic shadowing below the area probably because of its diffuseness
associated syndromes
- none
references
1. abbitt pl, mcilhenny j prenatal detection of gallstones j clin ultrasound 18: 202-204
2. heijne l, ednay d the development of fetal gallstones demonstrated by ultrasound radiog 51:155-156