Fecal Excretion of Rose Bengal I131 in the Diagnosis of Obstructive Jaundice in Infancy with Special Reference to Biliary Atresia

PEDIATRICS ◽  
1971 ◽  
Vol 48 (6) ◽  
pp. 966-969
Author(s):  
João Gilberto Maksoud ◽  
Anneliese Fischer Thom ◽  
Julio Kieffer ◽  
Virgilio A. Carvalho Pinto
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Biliary Atresia ◽  
Special Reference ◽  
Rose Bengal ◽  
Poor Prognosis ◽  
Surgical Intervention ◽  
Correct Diagnosis ◽  
Fecal Excretion ◽  
The Poor

Despite the poor prognosis of biliary atresia, there are a small number of cases in which early surgery will be of real benefit. Every effort must therefore be made to arrive at the correct diagnosis as quickly as possible so as not to delay surgical intervention. In our experience, FERB I131 has been the most reliable diagnostic test; we are convinced that this test must be done in every case in which the differential diagnosis of neonatal or infantile jaundice is not clear.

THE RED CELL PEROXIDE HEMOLYSIS TEST IN THE DIFFERENTIAL DIAGNOSIS OF OBSTRUCTIVE JAUNDICE IN THE NEWBORN PERIOD

PEDIATRICS ◽  
1971 ◽  
Vol 48 (4) ◽  
pp. 562-565
Author(s):  
Bertram H. Lubin ◽  
Robert L. Baehner ◽  
Elias Schwartz ◽  
Stephen B. Shohet ◽  
David G. Nathan
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Biliary Atresia ◽  
Rose Bengal ◽  
Biliary Obstruction ◽  
The Other ◽  
Neonatal Hepatitis ◽  
Red Cell ◽  
Newborn Period ◽  
Hemolysis Test

The erythrocyte peroxide hemolysis test (PHT) was compared to the I131 rose bengal excretion test (RBE) in the detection of complete biliary obstruction in the newborn period. Twenty-three infants with obstructive jaundice were studied. In 16 infants with surgically proven biliary atresia both the PHT and RBE were abnormal. During the course of evaluation of the other seven patients, with neonatal hepatitis, the PHT was normal in six and abnormal in one, whereas, RBE was normal in two patients and abnormal in five. The simplicity and reliability of the PHT and the ease with which it can be repeated indicate that it may be more valuable than the RBE in evaluating the cause of obstructive jaundice in infants.

Malignant Deciduoid Mesothelioma: A Diagnostic Challenge

2005 ◽  
Vol 129 (3) ◽  
pp. 403-406 ◽  
Author(s):  
Najat Mourra ◽  
Cecilede Chaisemartin ◽  
Isabelle Goubin-Versini ◽  
Rolland Parc ◽  
Jean-Francois Flejou
Keyword(s):  
Differential Diagnosis ◽  
Cesarean Section ◽  
Tumor Cells ◽  
Elderly People ◽  
Young Women ◽  
Poor Prognosis ◽  
Diagnostic Challenge ◽  
Keratin 5 ◽  
The Poor ◽  
Rare Phenotype

Abstract Malignant deciduoid mesothelioma, a rare phenotype of epithelioid mesothelioma, arises more commonly from the peritoneum of young women, but it is also reported in the pleura of elderly people. We report a case of malignant deciduoid mesothelioma that occurred in a 41-year-old woman after cesarean section and was initially misdiagnosed as pseudotumoral deciduosis. Microscopically, the tumor was entirely composed of deciduoid areas, and only scattered tumor cells were positive for calretinin and keratin 5/6. The patient died 14 months after the first operation. This observation confirms the poor prognosis of this entity and the importance of the differential diagnosis of pseudotumoral deciduosis.

Differential diagnosis of pseudotrisomy 13 syndrome

2012 ◽  
Vol 1 (1-2) ◽  
Author(s):  
Danízar Vásquez Carlón ◽  
Margarita Alvarez de la Rosa Rodríguez ◽  
Ana I. Padilla Pérez ◽  
Ingrid Martínez Wallin ◽  
Juan M. Troyano Luque
Keyword(s):  
Differential Diagnosis ◽  
Prenatal Diagnosis ◽  
Poor Prognosis ◽  
Autosomal Recessive ◽  
Literature Search ◽  
Normal Karyotype ◽  
Autosomal Recessive Disorder ◽  
Limited Information ◽  
The Poor ◽  
Similar Phenotype

AbstractPseudotrisomy 13 syndrome is determined by the combination of three findings: holoprosencephaly, postaxial polydactyly, and a normal karyotype. We report two cases of a prenatal diagnosis of pseudotrisomy 13 syndrome and one case of a suspected hydrolethalus syndrome, another disorder with a similar phenotype and karyotype. Thorough literature search yields limited information, and the genetic cause of this syndrome remains unclear; however, it is thought to be monogenic and inherited as an autosomal recessive disorder. Given the poor prognosis and the easily recognizable malformations associated with this disease, it is important to perform an early diagnosis.

Mycotic Pseudotumor of the Breast Secondary to Cryptococcal Infection: Report of Three Rare Cases and Literature Review

2021 ◽  
pp. 106689692110604
Author(s):  
Velaphi Glenda Makhubela ◽  
Moshawa Calvin Khaba
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Literature Review ◽  
Surgical Intervention ◽  
Fungal Infections ◽  
Correct Diagnosis ◽  
Breast Mass ◽  
Breast Masses ◽  
Cryptococcal Infection ◽  
Breast Malignancies

Breast masses in clinical practice are often investigated primarily for neoplastic conditions. Breast fungal infections are unusual, and few cases have been reported in the literature. The differential diagnosis for a breast mass should not be limited to neoplastic conditions as there are treatment implications. The correct diagnosis is associated with reduced and unwanted cases of surgical intervention. We describe 3 cases of cryptococcal infection of the breast that clinically masqueraded as breast malignancies.

PROBLEMS IN NEONATAL OBSTRUCTIVE JAUNDICE

PEDIATRICS ◽  
1964 ◽  
Vol 33 (5) ◽  
pp. 735-748
Author(s):  
Dale E. Bennett
Keyword(s):  
Obstructive Jaundice ◽  
Biliary Atresia ◽  
Giant Cell ◽  
Poor Prognosis ◽  
Neonatal Hepatitis ◽  
Final Conclusion ◽  
High Morbidity ◽  
Bile Duct Proliferation ◽  
Hazardous Procedure ◽  
Giant Cell Hepatitis

All cases of neonatal obstructive jaundice at St. Louis Children's Hospital were reviewed. The total of 57 included 32 cases of extrahepatic biliary atresia and 16 biopsy-proven cases of giant-cell hepatitis. As a result, the author has reached the following conclusions: Giant-cell hepatitis can be distinguished from extrahepatic atresia in almost all cases by study of a liver biopsy. The important morphologic criteria include the presence in atresia of bile duct proliferation and of intraductal bile stasis, and the absence of significant hepatic architectural disorganization early in the course of the disease. Clinical data and most laboratory tests are of little use in distinguishing between atresia and neonatal hepatitis. Serial bilirubin determinations are useful, as falling levels over a period of weeks is strong evidence for hepatitis. At laparotomy cholangiography is the most valuable diagnostic tool, with frozen section of value when radiographic studies cannot be made. Biliary atresia carries an extremely poor prognosis, for few patients have a correctable lesion (12% in this series). Furthermore, the mortality and morbidity of biliary tract surgery in infants is high, irrespective of the age of the patient at operation. This poor prognosis is not due to delay in operation, since cirrhosis and hepatic insufficiency develop relatively late in biliary atresia. Delay of operation until age three months will adversely affect only a very rare patient with atresia. Neonatal hepatitis is a frequent cause of neonatal obstructive jaundice. Exploratory laparotomy in these patients has a high morbidity and mortality, especially when a prolonged ductal dissection is performed. Early operation (4-8 weeks) will result in more cases of hepatitis being subjected to a hazardous procedure. There is evidence to indicate that if operation is delayed until 3 months of age, many of these patients will show evidence of resolution of their disease, especially a serial fall in bilirubin, and need not be explored. It is the final conclusion of the author that the management of obstructive jaundice in this age group should be conservative, and that operation should not be performed until a patient is three months of age, and even later if a falling trend is noted in serial bilirubins.

Cystic Biliary Atresia: A Wolf in Sheep's Clothing

2013 ◽  
Vol 79 (9) ◽  
pp. 870-872 ◽  
Author(s):  
Sarah J. Hill ◽  
Matthew S. Clifton ◽  
Sarkis C. Derderian ◽  
Mark L. Wulkan ◽  
Richard R. Ricketts
Keyword(s):  
Surgical Treatment ◽  
Obstructive Jaundice ◽  
Biliary Atresia ◽  
Neonatal Jaundice ◽  
Surgical Intervention ◽  
Institutional Review Board ◽  
Significant Delay ◽  
Institutional Review ◽  
Improved Outcomes ◽  
Cystic Biliary Atresia

Neonatal obstructive jaundice is frequently explained by biliary atresia (BA) or the presence of a choledochal cyst (CC). Cystic biliary atresia (CBA) has been a proposed as a subtype of BA with projected improved outcomes. We aimed to characterize these lesions further. We conducted an Institutional Review Board-approved review of all patients treated for obstructive jaundice at our tertiary children's hospital over 10 years. Over the decade we evaluated 91 children with obstructive jaundice: 13 CBA, 52 BA, and 26 CC. Patients with isolated CBA and BA were diagnosed significantly earlier than those with CC (15.9, 54, and 281 days, respectively; P = 0.0001). There was a significant delay between diagnosis and surgical intervention for patients with CBA compared with BA: 17 days versus 5.7 days ( P = 0.004). There was no difference in rate of transplant between CBA and BA (31 vs 50%; P = 0.35). The time from surgery until transplant was 13.9 and 18.6 months for CBA and BA, respectively ( P = 0.62). Although radiographically similar to CC, CBA behaves similarly to isolated BA. Delay in recognition and surgical treatment may affect outcomes and lead to an increased incidence of liver failure. The presence of a cystic biliary malformation in the setting of neonatal jaundice should be regarded as CBA until proven otherwise.

scholarly journals Mirizzi syndrome mimicking cholangiocarcinoma. Case report

2020 ◽  
Vol 50 (2) ◽  
Author(s):  
Gabriel Lorente Mitsumoto ◽  
Lucas Augusto Monetta da Silva ◽  
Mauricio Alves Ribeiro ◽  
Mariana Martins Tocchio ◽  
Nátalie Emy Yvamoto ◽  
...  
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Preoperative Diagnosis ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Correct Diagnosis ◽  
Rare Condition ◽  
Mirizzi Syndrome ◽  
Biliary Injury ◽  
Review Of The Literature

Mirizzi syndrome (MS) is a rare condition whose clinical presentation is unspecific, with obstructive jaundice being the most common form. MS is often not recognized at initial presentation, which can result in morbidity and biliary injury. Preoperative diagnosis is uncommon and over 50% of patients with MS are diagnosed during surgery. There are no clinical features to distinguish MS from cholangiocarcinoma, except that patients with cholangiocarcinoma are on average ten years older than patients with MS. We report the case of a 51-year-old female patient who presented with jaundice and weight loss. Following investigation with laboratory and imaging exams, the initial diagnosis was Bismuth II cholangiocarcinoma. The patient underwent surgical intervention, and anatomopathological examination of the specimen showed the correct diagnosis to be MS. Despite the rarity of its incidence, physicians must keep MS in mind as a possible differential diagnosis for cholangiocarcinoma and vice-versa. We discuss this case in the context of a brief review of the literature on Mirizzi syndrome mimicking cholangiocarcinoma.

Spontaneous Perforation of the Extrahepatic Bile Ducts in an Infant

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 601-603
Author(s):  
Dan Andersson ◽  
Ingemar Helin ◽  
Sven-Caspar Nettelblad ◽  
Clas-Göran Cederlund
Keyword(s):  
Surgical Treatment ◽  
Obstructive Jaundice ◽  
Biliary Atresia ◽  
Bile Ducts ◽  
Surgical Intervention ◽  
Rare Condition ◽  
First Year ◽  
Spontaneous Perforation ◽  
Extrahepatic Bile Ducts ◽  
First Year Of Life

Spontaneous perforation of the extrapepatic bile ducts, with an accumulation of bile in the peritoneal cavity, is a rare condition. Nevertheless, it is second in frequency to biliary atresia as the cause of obstructive jaundice during the first year of life.1 Although approximately 60 cases of this condition have been described in the literature, it is only occasionally listed in pediatric textbooks. Nevertheless, it is important that the condition be recognized in time to perform lifesaving surgical intervention. We therefore consider it instructive to present a patient with the classic features of this condition who was cured by surgical treatment on the 29th day of life.

Can conversation analytic findings help with differential diagnosis in routine seizure clinic interactions?

2016 ◽  
Vol 12 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Katie Ekberg ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Errors ◽  
Epileptic Seizures ◽  
Routine Clinical Setting ◽  
Choice Of Treatment ◽  
Transient Loss ◽  
Factual Content ◽  
Patient’S History ◽  
Linguistic Methods

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.

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