Demographics:
1 month old, Male
Indication:
Direct hyperbilirubinemia (born at 24 weeks)
Findings
- Gallbladder is visualized but is decompressed
- Branching linear echogenic foci throughout the liver with a peripheral predominance
- Liver is otherwise normal in size and appearance
- No intrahepatic or extrahepatic biliary duct dilation
- Increased right renal cortical echogenicity without hydronephrosis or focal mass
- Echogenic, thickening bowel wall in the right upper quadrant
- Visualized portions of the pancreas and aorta are normal in appearance
Diagnosis
Pneumatosis and portal venous gas
Sample Report
Branching linear echogenic foci throughout the liver with a peripheral predominance, concerning for portal venous gas. Thickened, echogenic bowel wall in the right upper quadrant, concerning for pneumatosis. Together, these findings are highly concerning for bowel ischemia. Recommend surgery consultation.
Gallbladder is visualized but is decompressed. These findings are not consistent with biliary atresia.
Liver is otherwise normal in size and appearance with no biliary duct dilation.
Increased right renal cortical echogenicity, which can be seen with medical renal disease. No hydronephrosis.
Discussion