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Abdominal pseudotumor in childhood: distended gallbladder with parenteral hyperalimentation
Insights
Children receiving parenteral nutrition can develop palpable, distended gallbladders. This common finding, identified via sonography, resolves with oral feeding, distinguishing it from other abdominal masses.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Neonatal Care
Background:
- Total parenteral hyperalimentation (TPN) is a critical nutritional support method for children unable to consume food orally.
- Abdominal masses in children require accurate diagnosis to differentiate benign findings from serious pathologies.
- Gallbladder function and distension in pediatric patients receiving TPN are not well-characterized.
Observation:
- Palpable upper abdominal masses were noted in two children undergoing TPN.
- Abdominal sonography revealed these masses to be significantly distended gallbladders.
- Further sonographic evaluation of four additional TPN patients showed gallbladder distension in three, suggesting a common occurrence.
Findings:
- Gallbladder distension is a frequent finding in pediatric patients receiving TPN, particularly during periods of fasting.
- Sonographic imaging is effective in identifying and characterizing gallbladder distension in this population.
- Initiation of oral feedings led to a reduction in gallbladder dimensions in follow-up examinations.
Implications:
- Clinicians should consider gallbladder distension as a potential cause of palpable abdominal masses in children on TPN.
- Sonography is a valuable tool for diagnosing TPN-associated gallbladder distension, aiding in differential diagnosis.
- This finding highlights the importance of monitoring gallbladder status in pediatric patients receiving long-term parenteral nutrition.
Abstract:
Two children receiving total parenteral hyperalimentation had palpable upper abdominal masses. Sonography showed these masses to be distended gallbladders. Sonograms of four other children receiving parenteral hyperalimentation were examined to determine if gallbladder distension in these cases was coincidental or common; three of four also had gallbladder distension. Follow-up sonograms after initiation of oral feedings in two children showed reduced gallbladder dimensions. Children can have palpable, distended gallbladders while fasting and receiving parenteral hyperalimentation. Sonography can differentiate distended gallbladders from other abdominal masses.