LIVER Flashcards
First line of investigation in any suspected abdominal pathology in children
US
Does the liver change quick?
NO the liver has a very large functional reserve and may need to suffer extensive disease before dysfunction becomes clinically apparent
When imaging pediatric liver all _______must be acquired
‘adult’ landmarks
Liver echogenicity to kidneys
echogenic
Most common hepatic mass in the neonate
Hemangioma
Hemangioma arrise from
AV malformations
2 types of hemangioma
Hemangioendotelioma
Cavernous hemangioma
what is hemangioendothelioma
Blood filled spaces with multilayered endotelium
what is cavernous hemangioma
single layered endotelium
who do hemangioendothelioma affect
infants less than 6 months of age
hemangioendothelioma associated with
skin hemangiomas
clinical presentations of hemangioendothelioma (3)
hepatomegaly
congestive heart failure
hemoperitoneum from rupture
asymptomatic hemangioendothelioma will
go away on its own accord
hemangioendothelioma sono appearance (5)
single or multiple varying echo and size contains “fine, linear foci of calcium” may have enhancement vascular
Cavernous Hemangioma 3x more likely in
girls
clinical presentation of Cavernous Hemangioma (4)
hepatomegaly (palpable)
obstructive jaundice
bowel obstruction (vomiting)
respiratory insufficiency
Cavernous Hemangioma treatments is
lobectomy or resection
only if large and threatening health
Cavernous Hemangioma sono appearance (5)
- well defined
- hyperechoic (multiple interfaces between walls of the blood-filled vessels)
- can be hypoechoic (atypical)
- enhancement
- vascular
(looks like what it does in adults )
Mesenchymal Hamartoma cause
Congenital-arises from connective tissue of the portal tracts
Mesenchymal Hamartoma clinical presentation
painless abdo swelling
sono feature difference of Mesenchymal Hamartoma from hemangioma
it is avascular
adenoma highly associated with
glycogen storage disease
is FNH common? and appearance
no, rare
isoechoic with blood in center shown by doppler
_____ of all liver tumours are malignant
2/3
hepatoblastoma US appearance (6)
Solitary multinodular mass Heterogeneous Hyperechoic ill-defined borders Areas of necrosis and hemorrhage Calcifications
hepatocellular carcinoma (hepatoma) find in children of what age
older than 3
lab findings for hepatocellular carcinoma (hepatoma)
increased AFP, hypoglycemia
clinical presentations of hepatocellular carcinoma (hepatoma) (5)
sudden liver failure due to thrombosis of portals or HVs hepatomegaly pain GI bleeding, anemia ascites
sono features of hepatocellular carcinoma (hepatoma) (5)
similar to Hepatoblastoma solid hyperechoic mass involving the entire liver well-defined or ill-defined borders anechoic areas within mass from necrosis hypo-anechoic halo around mass
