Presentation
Mother is a Group B Streptococcus (GBS) carrier. Noted liver calcification during bedside antenatal scan. No dysmorphic features. For further assessment.
Patient Data
The liver is normal in size measuring 3.9 cm in span. Normal echogenicity and echotexture with smooth liver margins. Hyperechoic lesion at segment VII of liver measuring 0.3x0.5x0.5cm (APxWxCC) with posterior shadowing without any Doppler signal within, in keeping with calcification.
Gallbladder is normal in configuration. It measures 7mm in width and 27mm in length. [gallbladder length: width ratio = 3.9 (normal < 5)]. No pericholecystic fluid or gallbladder wall thickening. Smooth gallbladder mucosal lining.
No choledochal cyst.
No biliary tree dilatation.
No triangular cord sign (TC sign). The echogenic anterior wall of the right portal vein is 1.2 mm (normal < 4 mm).
The portal vein is patent and normal in caliber measuring 3mm (normal range for age 3mm). Hepatic artery is not dilated measuring 0.9mm (Normal < 1mm). Ratio hepatic artery: portal vein is 0.3 (normal <0.45).
Spleen is normal measuring 3.5cm.
Pancreas is obscured by bowel gas.
Case Discussion
There is parenchymal calcification at segment VII of liver. Otherwise, no sonographic evidence of biliary atresia.
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