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Yankov I, Boyanov N, Aleksova L, Ivanov B, Moshekov E, Chatalbashev D, Stefanova P. Gallbladder polyp in children - a rare finding during ultrasound examination. J Ultrason 2022; 22:e64-e66. [PMID: 35449699 PMCID: PMC9009351 DOI: 10.15557/jou.2022.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/01/2021] [Indexed: 12/02/2022] Open
Abstract
Gallbladder polyps are a relatively rare finding in children. The increased use of high-resolution ultrasound in childhood allows to detect gallbladder lesions in young patients. A precise diagnosis can be established using different imaging series. Abdominal contrast-enhanced ultrasound examination provides the most accurate imaging information about the nature and size of the lesion. This is important for further decisions regarding patient referral for cholecystectomy. The object of this study was to present a case of gallbladder polyp diagnosed and followed up by contrast-enhanced ultrasound.
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Affiliation(s)
- Ivan Yankov
- Department of Pediatrics and Medical Genetics, Medical University of Plovdiv, Bulgaria.,Department of Pediatric Gastroenterology, University Hospital "St. George", Plovdiv, Bulgaria
| | - Nikola Boyanov
- Second Department of Surgical Diseases, University Hospital "St. George", Plovdiv, Bulgaria
| | - Lyubka Aleksova
- Department of Pediatric Surgery, University Hospital "St. George", Plovdiv, Bulgaria
| | - Biser Ivanov
- Department of Pediatric Surgery, University Hospital "St. George", Plovdiv, Bulgaria
| | - Evgeniy Moshekov
- Department of Pediatric Surgery, University Hospital "St. George", Plovdiv, Bulgaria
| | - Dimitar Chatalbashev
- Department of Pediatric Gastroenterology, University Hospital "St. George", Plovdiv, Bulgaria
| | - Penka Stefanova
- Department of Pediatric Surgery, University Hospital "St. George", Plovdiv, Bulgaria
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Stevens JP, Dakshinamoorthy J, Gill AE, Parker P, Geem D, Berauer JP, Schoen B, Gupta N, Romero R. Undiagnosed Metachromatic Leukodystrophy Presenting as Severe Gastrointestinal Bleeding and Cholestasis from Hemobilia. JPGN REPORTS 2021; 2:e122. [PMID: 37206461 PMCID: PMC10191546 DOI: 10.1097/pg9.0000000000000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/20/2021] [Indexed: 05/21/2023]
Abstract
Metachromatic leukodystrophy (MLD) is a neurodegenerative disorder caused by the accumulation of lipids called sulfatides throughout the nervous system. Sulfatides can also collect in other organs throughout the body including the gallbladder where they form polyps. Gallbladder polyps rarely have been found to bleed in patients with known MLD, presumably due to polyp shearing. Here we present a case of a child with autism presenting with severe gastrointestinal bleeding and direct hyperbilirubinemia, requiring significant resuscitation and biliary drain placement to tamponade ongoing bleeding. Subsequent neurologic and genetic investigation led to the diagnosis of MLD, with laparoscopic cholecystectomy revealing extensive, elongated gallbladder polyps. Clinicians who care for patients with MLD, including gastroenterologists who manage their progressive oropharyngeal dysphagia, should be aware of the risk for this life-threatening complication. Moreover, pediatric gastroenterologists and hepatologists should maintain a high index of suspicion for MLD in new patients presenting with developmental regression and gastrointestinal bleeding.
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Affiliation(s)
- James P. Stevens
- From the Division of Gastroenterology, Hepatology, and Nutrition, Children’s Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | | | - Anne Elizabeth Gill
- Department of Radiology & Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University School of Medicine, Atlanta, GA
| | - Paul Parker
- Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Duke Geem
- From the Division of Gastroenterology, Hepatology, and Nutrition, Children’s Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - John-Paul Berauer
- From the Division of Gastroenterology, Hepatology, and Nutrition, Children’s Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Bess Schoen
- From the Division of Gastroenterology, Hepatology, and Nutrition, Children’s Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Nitika Gupta
- From the Division of Gastroenterology, Hepatology, and Nutrition, Children’s Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Rene Romero
- From the Division of Gastroenterology, Hepatology, and Nutrition, Children’s Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
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