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Thursday, April 1, 2010

Gallstones in neonates















Gall bladder calculi in a neonate? This ultrasound image shows just that!!. Not one stone, a gall bladder packed with calculi in a neonate!
See: http://www.ultrasound-images.com/ped-abdomen.htm (case-8)
This might sound like big bad news for a tiny baby. The good part is that gallstones in infants and neonates tend to spontaneously disappear within a few weeks. I am not sure of the mechanism involved, either they dissolve or are passed via the bile duct into the GI tract. In fact at this page http://www.ultrasound-images.com/fetal-abdomen.htm , (see case-1), there is a case showing gall bladder calculi in a fetus. So, in the above case (neonatal GB calculi), we must conclude that the gallstones actually formed way up in the intrauterine period, possibly the last 3 months of gestation.
Studies have shown that gall stones (cholelithiasis) in infants/ children are mainly composed of dark bile pigment (calcium bilirubinate) whilst in adults the calculi are mainly of cholesterol crystals.

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