Transient Hepatic Nodular Lesions Associated with Patent Ductus Venosus in Preterm Infants

Abstract

We report on two cases of low-birth-weight preterm infants with patent ductus venosus associated with hepatic hypoechoic lesions of the fourth segment in an otherwise normal liver. Although tumorlike hepatic lesions have been previously reported in association with portosystemic shunts in children and adults, they were never described in preterm infants during physiological patency of ductus venosus. In our patients, hepatic lesions disappeared shortly after the spontaneous ductus closure. Physiopathologic interactions are discussed regarding altered portal blood supply caused by ductus venosus shunt.

Inherited liver shunts in dogs elucidate pathways regulating embryonic development and clinical disorders of the portal vein

“…From several literature reviews and case reports, the disease appears to be more prevalent in the Japanese population. In total, there have been 173 human cases of EHPSS reported (Caruso et al 2010; Franchi-Abella et al 2010; Kobayashi et al 2010; Konstas et al 2010; Lautz et al 2011; Newman et al 2010; Ohno et al 2008) and 89 human cases of IHPSS (Ferrero et al 2010; Franchi-Abella et al 2010; Kamimatsuse et al 2010; Konstas et al 2010; Ohno et al 2008; Schierz et al 2011; Stringer 2008; Tsai et al 2009; Uchino et al 1999; Yoshimoto et al 2004). In human EHPSS, a classification has been made based on the presence or absence of portal blood flow (Abernethy 1793).…”

Clinical Significance of Ductus Venosus Waveform as Generated by Pressure- volume Changes in the Fetal Heart

“…A DV flow effect in neonatal liver and its persistence after birth remain an unclear subject [90][91][92]. Few cases have been described so far, and diagnoses occurred not only in early childhood but also in adulthood or even on autopsy studies [93][94][95][96].…”

“…representing hepatic, pulmonary and cardiac dysfunction [97][98][99]. Manifestations reported include cholestatic jaundice [93][94][95][96][97][98][99][100], hepatic encephalopathy [91,94,95,99], massive gastrointestinal bleeding [98]; acute liver failure [99,101]; respiratory distress [102] and pulmonary arteriovenous fistulae [103,104], and tumor-like hepatic lesions [92,105]. A child with a single ventricle, who presented with spontaneous microbubbles on echocardiography, was found to have a PDV [106].…”

Meconial peritonitis in a rare association of partial ileal apple-peel atresia with small abdominal wall defect

“…21 L'anastomosi primaria andrebbe praticata solo nei pazienti con atresia prossimale, mentre nelle forme di atresia distale, al fine di decomprimere e detendere le anse intestinali iperdistese, possono essere confezionate delle stomie provvisorie. In ogni caso è opportuno sottolineare come molte altre condizioni concomitanti (prematurità, gemellarità, anomalie associate, infezioni nosocomiali, mutazioni geniche, …) 22,23,24,25 possano giocare un ruolo significativo nel determinare i tassi di morbilità e mortalità in epoca neonatale, con un effetto cumulativo sull'outcome a breve e lungo termine. Nel nostro paziente abbiamo optato per l'esecuzione di una stomia provvisoria ed è stata praticata la manipolazione manuale, sia per l'esplorazione delle anse intestinali che per la digitoclasia delle aderenze, è stata somministrata nutrizione parenterale totale per tutta la durata del ricovero, senza tuttavia riuscire ad ottenere una soddisfacente funzione intestinale, andando progressivamente incontro ad insufficienza intestinale.…”