During a 1-year period, a prospective ultrasound (US) study of the biliary tract was performed in 41 neonates receiving total parenteral nutrition (TPN). Gallbladder sludge appeared in 18 neonates (44%) after a mean period of 10 days of TPN. The occurrence of this abnormality seems related to three main factors: prematurity with immaturity of the enterohepatic circulation of bile acids, duration of TPN, and lack of enteral nutrition. In five neonates (12%), an evolution of sludge to "sludge balls" was observed. Two neonates (5%) went on to develop uncomplicated gallstones and a spontaneous resolution occurred in one of them 6 months after the examination. This finding suggests conservative management in such cases. However, since cholecystitis or biliary tract obstruction are classical complications in older children, a US survey of neonates receiving TPN is useful to follow the abnormal gallbladder content, and rapid introduction of enteral feeding is advisable.
Pancreatic metastasis from renal cell carcinoma is exceptional, but may appear many years after initial diagnosis and radical nephrectomy of an apparently limited tumour. We report one case of an asymptomatic isolated pancreatic metastasis discovered fortuitously, 21 years after right radical nephrectomy for a low-grade renal cancer.
In 1969, a 47-year-old man underwent right nephrectomy for renal cell carcinoma of “low-grade malignancy”. At this time, no metastases were evident and he remained well on follow-up.
This article is based on the same population that was previously reported. In this paper, we report the results concerning the fetal limb bones. Growth charts and velocity charts were produced for the humerus, ulna, femur, and tibia. The results are compared with those of the cross-sectional literature.
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