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超声检测胎儿胆石症

Sonographic Detection of Fetal Cholelithiasis.

作者信息

Gică Nicolae, Radoi Andra, Gică Corina, Panaitescu Anca Maria, Peltecu Gheorghe, Huluță Iulia

机构信息

Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania.

Obstetrics and Gynecology Department, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

出版信息

Diagnostics (Basel). 2023 Sep 11;13(18):2900. doi: 10.3390/diagnostics13182900.

Abstract

Fetal biliary lithiasis is a benign condition characterized by the presence of gallstones in the gallbladder of a developing fetus. It is typically detected incidentally during a routine obstetric echography. The incidence of this condition varies from 0.03% to 2.3%. In most cases, fetal cholelithiasis resolves spontaneously and has an excellent prognosis. However, there are certain risk factors that may contribute to its development. Maternal factors that increase the risk of fetal cholelithiasis include placental abruption, elevated estrogen levels, narcotic use, diabetes, enteral nutrition, and specific medications, such as ceftriaxone, furosemide, and prostaglandin E2. Fetal factors that can contribute to the condition include Rhesus or ABO blood group incompatibility, congenital anomalies affecting the cardiovascular, gastrointestinal, or urinary systems, twin pregnancies with the fetal demise of one twin, genetic anomalies such as trisomy 21, chromosomal aberrations, cystic fibrosis, growth restriction, oligohydramnios, hepatitis, or idiopathic causes. Usually, the gallstones spontaneously resolve before or after birth without requiring specific treatment. However, in rare instances, complications can arise, such as the formation of biliary sludge, inflammation of the gallbladder (cholecystitis), or obstruction of the bile ducts. If complications occur or if the gallstones persist after birth, further evaluation and management may be necessary. Treatment options can include medication, minimally invasive procedures, or, in severe cases, surgical removal of the gallbladder.

摘要

胎儿胆石症是一种良性病症,其特征是发育中的胎儿胆囊内存在胆结石。它通常在常规产科超声检查时偶然被发现。这种病症的发病率在0.03%至2.3%之间。在大多数情况下,胎儿胆石症会自发消退,预后良好。然而,有某些危险因素可能会促使其发生。增加胎儿胆石症风险的母体因素包括胎盘早剥、雌激素水平升高、使用麻醉剂、糖尿病、肠内营养以及特定药物,如头孢曲松、呋塞米和前列腺素E2。可能导致这种病症的胎儿因素包括恒河猴或ABO血型不合、影响心血管、胃肠道或泌尿系统的先天性异常、一个双胎胎儿死亡的双胎妊娠、21三体等遗传异常、染色体畸变、囊性纤维化、生长受限、羊水过少、肝炎或特发性原因。通常,胆结石在出生前或出生后会自发消退,无需特殊治疗。然而,在罕见情况下,可能会出现并发症,如胆泥形成、胆囊炎或胆管梗阻。如果出现并发症或胆结石在出生后持续存在,则可能需要进一步评估和处理。治疗选择可以包括药物治疗、微创手术,或在严重情况下手术切除胆囊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd9a/10528813/e6b1e8905238/diagnostics-13-02900-g001.jpg

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