Su Wan-Hsin, Chao Hsun-Chin, Chen Mi-Chi, Lai Ming-Wei, Chen Chien-Chang, Yeh Pai-Jui
Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
Biomed J. 2024 Dec;47(6):100717. doi: 10.1016/j.bj.2024.100717. Epub 2024 Mar 12.
With the widespread use of abdominal ultrasonography (US), incidental detection of common bile duct (CBD) dilatation is common in pediatric populations. This study investigated the causes and clinical significance of CBD dilatation in children without biliary symptoms, jaundice, or causative lesions in US.
We retrospectively reviewed pediatric patients with CBD dilatation from July 2013 to June 2023. All cases were detected via abdominal US. We analyzed the patients' clinical manifestations, laboratory data, diagnosis, underlying diseases, and clinical course.
In a total of 687 patients enrolled, 338 met inclusion criteria (90 in hepatobiliary, 248 in CBD dilatation group). Of 128 patients with incidental CBD dilatation who underwent regular US examinations, 91 (71.1%) experienced resolution during follow-up. The proportion of patients with intrahepatic duct dilatation was significantly higher in the non-resolution group (p = 0.038). General health examination group had significant smaller CBD diameter compared to the gastrointestinal and infection groups. Correlation analysis found starting point of resolution decline at 3.24 mm (all-inclusive) and 2.51 mm (infant group) CBD diameter.
Most children with incidental CBD dilatation did not have abnormal hepatobiliary function or other sonographic abnormalities. They usually remained asymptomatic and experienced uneventful clinical courses.
随着腹部超声检查(US)的广泛应用,小儿群体中偶然发现胆总管(CBD)扩张很常见。本研究调查了无胆道症状、黄疸或超声检查中致病病变的儿童CBD扩张的原因及临床意义。
我们回顾性分析了2013年7月至2023年6月期间患有CBD扩张的儿科患者。所有病例均通过腹部超声检查发现。我们分析了患者的临床表现、实验室数据、诊断、基础疾病及临床病程。
总共纳入687例患者,其中338例符合纳入标准(肝胆组90例,CBD扩张组248例)。在128例接受定期超声检查的偶然发现CBD扩张的患者中,91例(71.1%)在随访期间扩张消失。未消失组肝内胆管扩张患者的比例显著更高(p = 0.038)。一般健康检查组的CBD直径明显小于胃肠道和感染组。相关性分析发现,CBD直径在3.24毫米(所有患者)和2.51毫米(婴儿组)时扩张开始消失。
大多数偶然发现CBD扩张的儿童没有肝胆功能异常或其他超声异常。他们通常无症状,临床病程平稳。