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Published on: February 28, 2025
Different characteristics of infants diagnosed with congenital choledochal malformation prenatally or postnatally
Wei Chen1, Jia Geng2, Ya-Lan Tan3
1Department of Radiology, Children's Hospital of Soochow University, Suzhou, 215025, China.
Insights
Early diagnosis of congenital choledochal malformation (CM) in children leads to better outcomes. Prenatally diagnosed CM patients experienced less severe symptoms and faster recovery compared to those diagnosed postnatally.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Malformations
Background:
- Congenital choledochal malformation (CM) is a rare biliary tract anomaly.
- Early diagnosis and intervention are crucial for managing pediatric CM.
- Understanding clinical differences between prenatal and postnatal diagnosis is essential.
Purpose of the Study:
- To investigate the clinical significance of early diagnosis in congenital choledochal malformation (CM).
- To compare clinical and pathological characteristics of prenatally versus postnatally diagnosed CM patients.
- To evaluate the impact of diagnosis timing on treatment outcomes and recovery.
Main Methods:
- Retrospective analysis of 33 pediatric patients with confirmed CM.
- Patients categorized into prenatally and postnatally diagnosed groups.
- Comparison of clinical presentation, laboratory values, histopathology, and surgical outcomes.
Main Results:
- Postnatally diagnosed CM patients presented with more severe symptoms (abdominal pain, vomiting) and elevated liver enzymes (AST, GGT, TB).
- Histopathological findings indicated greater cyst wall congestion and fibrous hyperplasia in the postnatal group.
- While surgery and diet resumption took longer in the prenatal group, overall hospitalization was shorter.
Conclusions:
- Prenatal diagnosis of CM is associated with milder disease presentation and quicker recovery.
- Timely intervention in prenatally diagnosed CM patients leads to improved clinical outcomes.
- Early detection of CM significantly impacts patient management and prognosis.
Abstract:
The general condition, clinical and pathological characteristics, and treatment regimens of patients prenatally and postnatally diagnosed with congenital choledochal malformation (CM) were analyzed in order to investigate the clinical significance of early diagnosis, treatment, and intervention in CM. We retrospectively analyzed 33 children who were admitted to the Children's Hospital of Soochow University between 1 March 2010 and 31 May 2019, and their diagnosis of CM was confirmed by radiological, surgical and pathological findings. All the patients were under 36 months of age. The patients were divided into prenatally diagnosed and postnatally diagnosed groups. There were 16 and 17 CM patients in the prenatally and postnatally diagnosed groups, respectively, with a preponderance of females in both groups. Compared with the prenatally diagnosed group, the postnatally diagnosed group had a higher incidence of abdominal pain and vomiting (p < 0.05) and higher AST, GGT, and TB levels (p < 0.05). Although postoperative histopathological examination showed inflammation in both groups, congestion in the cyst walls and fibrous tissue hyperplasia were more significant in the postnatally diagnosed group (p < 0.05). In addition, operation time, length of time required to resume a normal diet after surgery, and total length of hospitalization differed between the 2 groups (p < 0.05), with the prenatally diagnosed group having a relatively longer operation time and taking longer to resume a normal diet after surgery. However, the total length of hospitalization in the prenatally diagnosed group was shorter than that in the postnatally diagnosed group. Compared with prenatally diagnosed CM patients, more symptoms, greater severity of symptoms, and more time to recovery after surgery were observed in postnatally diagnosed CM patients.
