Published in:
Open Access 01-05-2011 | Original Article
Pseudo Gallbladder sign in biliary atresia—an imaging pitfall
Published in: Pediatric Radiology | Issue 5/2011
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Background
Ultrasound (US) is used to identify causes of neonatal cholestasis. We describe a potential sonographic pitfall, the “pseudo gallbladder,” in biliary atresia (BA).
Objective
To describe the Pseudo Gallbladder sign (PsGB sign).
Materials and methods
Sonograms/clinical records of 20 confirmed BA infants and 20 non-BA cases were reviewed retrospectively. For the BA group, preoperative sonography and surgical and pathological findings were examined. For the non-BA group, sonographic features and pathological findings were examined. The PsGB sign is defined as a fluid-filled structure, located in the expected region of the gallbladder, measuring ≤ 15 mm in length but without a well-defined or normal-appearing gallbladder wall.
Results
A recognizable gallbladder and normal gallbladder wall were present in all non-BA infants. However, none of the BA infants had a sonographically normal gallbladder. Seventy-three percent of BA patients had a PsGB, and in 27% no gallbladder or gallbladder-like structure was detected.
Conclusion
A gallbladder-like structure in BA is common and can be misinterpreted as a normal gallbladder, delaying diagnosis and therapy. Recognition of this imaging pitfall, described here as the pseudo gallbladder sign, will help avoid this error.