Percutaneous cholecystography in children.

Abstract

Percutaneous cholecystography was performed on 13 children who had biliary system abnormalities: two had biliary hypoplasia, five had sclerosing cholangitis, three had cirrhosis, two had distal choledochal obstruction, and one had an obstructed portoenterostomy. In 12 patients transcholecystic cholangiography showed, without significant complications, the intra-and extrahepatic bile ducts. In one patient with primary sclerosing cholangitis, the intrahepatic bile ducts were not opacified satisfactorily; dilatation of the gallbladder required surgical drainage. The transcholecystic technique is indicated when the intrahepatic bile ducts are either mildly dilated or not dilated.

Sodium-Calcium Inter-Relationships with Specific Reference to Osteoporosis

“…Since PTH increases excretion of urinary cAMP in the process of stimulating adenylate cyclase (EC 4.6.1.1) in the renal tubules (Garel, 1987), urinary cAMP is considered to be a sensitive index of parathyroid function. Urinary cAMP has been shown to be significantly elevated in animals given salt supplements (80 g/kg diet) compared with control animals (Goulding, 1980h;Goulding & Campbell, 1983, 1 9 8 4~;Goulding & McIntosh, 1986;Goulding & Gold, 1986.…”

“…However, despite similarity in study design (subjects and Na loads), the observed increment in serum PTH with the imposition of the high-Na diets differed considerably among studies (Coe et al 1975;McCarron et al 1981 ;Breslau et al 1982). Interpretation of studies which examine PTH changes are made difficult by differences in sensitivity of the radioimmunoassays used, the pulsatile nature of serum PTH concentrations, and the possible haemodilution effect of Na loading (Slatopolsky et al 1982;Garel, 1987;Jubiz et al 1972;Magliaro, 1983).…”

Interventional Radiology in the Neonate and Young Infant

“…However, in 2 studies of transcholecystic cholangiography in pediatric patients, the intrahepatic ducts were well visualized. 43,44 There are 2 approaches to puncture the gall bladdertransperitoneal and transhepatic. To decrease the risk of bile peritonitis, we prefer the transhepatic route when possible.…”

Pathogenesis and Outcome of Biliary Atresia: Current Concepts

“…In North America, biliary atresia is then generally diagnosed at minilaparotomy by intraoperative cholangiography that fails to demonstrate a lumen in some portion of the extrahepatic biliary tree, by surgical findings of a fibrotic, nonpatent extrahepatic bile duct, and by characteristic findings on liver and bile duct histology, in the absence of other known etiologies (17). In some countries, percutaneous transhepatic cholecystography (105) or ERCP (101) are alternative tests to define the anatomy of the extrahepatic biliary tree. Caution must be entertained in assigning the diagnosis of biliary atresia and performing the portoenterostomy if the only findings are failure to visualize the common hepatic duct and intrahepatic ducts on cholangiography because these findings may represent hypoplastic but patent proximal biliary structures in those with Alagille syndrome (106).…”