KINDERRADIOLOGIE ONLINE - view radiology images and radiology cases
Lesen Sie diese Seite auf Deutsch   Read this page in English
The Peer Reviewed Pediatric Radiology Platform on the Web
ISSN: 1942-955X :: Publisher: EduRad ::Editor-In-Chief: Roland Talanow, MD, PhD  
Browse Browse || Search Search || Online Book Systematically Online Book Systematically || Discussion Forum Discussion Forum || News News || Submit a Case Submit a Case || Rules Rules |
Most Interesting Cases Most Interesting Cases || "Most Diligent" Authors "Most Diligent" Authors || Case of the Day Case of the Day || Teaching files Teaching files || Links Links |
Newsletter Newsletter || Start Start || Survey Survey || Your Opinion Your Opinion || My Profile My Profile || CME-Credits CME-Credits |
    Pediatric Radiology News / Ads / Jobs Get the Pediatric Radiology News as RSS feed !
    Send us your news or ads for free
  • Quantitative CT characterization of pediatric lung development using routine clinical imaging.... (Pediatr Radiol)
  • Liver MR Imaging in Children: Current Concepts and Technique.... (Radiographics)
  • Enhancing the role of paediatric ultrasound with microbubbles: a review of intravenous applications.... (Br J Radiol)
  • CME Kurs: Paediatric Body MRI

  • CME course: Paediatric Body MRI

  • Universitätsklinikum Jena sucht eine Ärztin/einen Arzt in Weiterbildung in Vollzeit

  • Kinderspital Zürich sucht Oberärztin / Oberarzt (100 %)

  • Kinderradiologische Oberärztin / Oberarzt gesucht

  • 2 Stellen in der Kinderradiologie - 1 Assistenzärztin/Assistenzarzt und 1 Oberärztin/Oberarzt in Voll- oder Teilzeit

  • Senior Paediatric Radiologist in Pediatric Radiology section needed

  • Facharzt als Oberärztin / Oberarzt in Sektion Kinderradiologie gesucht

  • Stellenangebot für Assistenzarzt (m/w) zur Facharztausbildung für RADIOLOGIE und/oder KINDERRADIOLOGIE

  • „Fellow“-Stelle zur Weiterbildung in Pädiatrischer Radiologie am Kinderspital Zürich

  • Fellow-Stelle Pädiatrische Neuroradiologie

  • FFF Kinderradiologie - Muskuloskelettale Radiologie im Kindesalter (Fit für den Facharzt)

  • Assistenzarzt für Kinderradiologe gesucht an Universitätsklinikum Schleswig-Holstein, Campus Kiel

  • Turnusarzt (m/w) in Ausbildung zum Facharzt (m/w) für Radiologie

  • Assistenzarzt (m/w) zur Weiterbildung im Schwerpunkt Kinderradiologie

  • Send us your news or ads for free

    Get the Pediatric Radiology News as RSS feed !


    Radiolopolis

    The dynamic Radiology community for education, research and practice


     

    Go to the top of the page   ID: 20040118215842 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

    Bookmark and Share


    | The Authors | Discussion | Write a Comment to this Case |
    | Evaluate this Case | Recommend this Case to a Colleague | Survey Results |
    | Citation | Similar Cases | Similar Cases in the Internet | Images to this Case |
     
    Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP)
    Ina Sorge. Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP). PedRad [serial online] vol 4, no. 1.
    URL: www.PedRad.info/?search=20040118215842


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Ina Sorge (Universität Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    8 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    Abdomen-Liver  

     
     Pediatric Radiology CasesMost likely etiology:

    physical  

     
     Pediatric Radiology CasesHistory:

    8 year-old girl with hereditary spherocytosis. In the course of a routine examination, a bile duct obstruction was found. After initial conservative therapy, an endoscopic extraction of the concrement was performed (ERCP).  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Through hemolysis, increased uric acid, which makes an obstruction in the bile ducts possible.  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Depiction of the concrement in the common bile duct (CBD), wich does not show an obvious acoustic shadow.




    MRI 1 <- view MRI 1

    MRI 1: (T2-weighted HASTE-Sequence): Depiction of the stone in the common bile duct (CBD) transversally; it is not completely signal free, which would speak for a calcified concrement, such as an oxalate stone.




    MRI 2 <- view MRI 2

    MRI 2: (mixed-weighted TRUFI-Sequence): Depiction of the stone in the common bile duct (CBD). It is noticeably dilated, a slight peripheral bilary duct dilatation is also seen.




    MRI 3 <- view MRI 3

    MRI 3: (MRCP-Image) Depiction of the stone in the common bile duct (CBD). This is noticeably dilated, a slight peripheral bilary duct dilatation is also seen. The pancreatic duct is not dilated, and is therefore not clearly seen.




    MRI 4 <- view MRI 4

    MRI 4: (MRCP-Image) One year after the endoscopic removal of the bilary duct stone, no proof of a stone on MRI nor on ultrasound. However, there is a scar related distal common bile duct stricture in the region of the papilla. Even the pancreatic duct is prominent, as well as the peripheral bilary ducts.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Peripheral bilary ducts: One year after the endoscopic removal of the bilary duct stone there is no proof of a stone. However, there is a scar related distal common bile duct stricture in the region of the papilla. The central as well as the peripheral bilary ducts are dilated(double duct sign).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Common bile duct dilatation (labelled as DC - ductus choledochus): One year after the endoscopic removal of the common bile duct stone, proof of a extrahepatic biliary obstruction with distal common bile duct dilatation on the sonogram.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Cholesterol concrement, Ureate concrement, Klatzkin tumor, Bilary duct polyp  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    A cholecystectomy is not recommended before the 6th year of life. The endoscopic removal of a distal, single stone is an alternative, but can (like in our case) lead to a papillary stenosis.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Biliary duct, MRCP, concrement, stone, bile stone, bilirubin, oxalate, spherocytosis, ERCP, stenosis, bilirubin stone, hereditary Spherocytosis, Sphincter of Oddi, major papilla stricture, Papilla Vateri stenosis, Wirsung duct, endoscopic stone removal, endoscopic stone extraction, double duct sign, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Ina Sorge. Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP). PedRad [serial online] vol 4, no. 1.
    URL: www.PedRad.info/?search=20040118215842  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Abdomen-Liver
    or in the region: Abdomen
    or in the tissue/organ: Liver
    or with the etiology: physical
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP)
    Ina Sorge. Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP). PedRad [serial online] vol 4, no. 1.
    URL: www.PedRad.info/?search=20040118215842


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP)
    Other cases by these authors:

    Search Ina Sorge in Medline Ina Sorge (8)   

    Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP)  
     
    Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP)
    Ina Sorge. Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP). PedRad [serial online] vol 4, no. 1.
    URL: www.PedRad.info/?search=20040118215842


     

    Which diagnosis have other collegues guessed?


    • Cholesterine concrement, papillary stenosis after ERCP
      Votes: 1 (11 %)


    • Bilirubine concrement, papillary stenosis after ERCP
      Votes: 7 (77 %)


    • Klatzkin tumor
      Votes: 0 (0 %)


    • Biliary duct polyp
      Votes: 1 (11 %)



        Total answers: 9

     
    Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP)
    Ina Sorge. Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP). PedRad [serial online] vol 4, no. 1.
    URL: www.PedRad.info/?search=20040118215842


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    How interesting was this case for you?
    (10 = most interesting || 1 = less interesting)
     
    Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP)
    Ina Sorge. Bilirubin Stone in Hereditary Spherocytosis, Papillary Stenosis after Endoscopic Stone Removal (ERCP). PedRad [serial online] vol 4, no. 1.
    URL: www.PedRad.info/?search=20040118215842


     




    Discussion >> Write Comment <<



      There are no comments available regarding this case.





     Write a comment to this case (With * marked fields have to be filled)

    Type in this number: 9961

    Name: *

    E-Mail:

    Website:

    Subject: *

    Text: *




     
      Pediatric Radiology Discussion Get the Pediatric Radiology Discussion as RSS feed !
      To the discussion forum
      To the discussion forum

      Get the Pediatric Radiology Discussion as RSS feed !

      © 2001-2016   www.kinderradiologie-online.de
      In cooperation with © Radiolopolis - Radiology Search - Radiology Teacher - PubMed Reader - Annotate - Radiology Lectures & Tutorials - Radiology Boards Preparation - Pediatric Radiology Links - Pediatric Radiology Information - Emergency Radiology - Lung Cancers - USMLE Forums - Cancer Staging Information - Chest Radiology - Radiology Case Report Journal
      For suggestions and questions: information@kinderradiologie-online.de
      Add this site to your favorites (CTRL+D)