[Ultrasonographic evaluation of the kidney, liver and spleen size in children]. / Evaluation échographique de la taille des reins, du foie et de la rate chez l'enfant.

BACKGROUND: The aim of our study was to establish a standard growth curve of renal, hepatic and splenic dimensions with respect to age, and to find if any relationship existed between these different curves. PATIENTS AND METHODS: One hundred and fifty abdominal ultrasound studies were obtained on 62 male and 88 female normal children free of any chronic disease, whose ages ranged from 0 to 15 years. Hepatic, splenic and renal dimensions were obtained in a similar and reproducible fashion for all patients. A statistical study of the measurements obtained compared to the age was performed by dividing the subjects into five groups according to age, and after calculating the mean size and variance. RESULTS: Standard growth curves for the liver, kidney and spleen were constructed. Compared to age, splenic size follows the same growth as that of the kidneys, with a constant ratio. The growth pattern of the liver parallel the renal curve with a mean difference of 2.72 cm. CONCLUSION: A moderate enlargement of spleen and liver is difficult to evaluate only by clinical examination. Ultrasound may detect it by using the kidney size as a reference.

[Cavernous dural fistulas: Importance of trans-ocular Doppler ultrasound in evaluating venous patency and therapeutic choices]. / Fistules durales caverneuses: intéret de l'écho-Doppler transoculaire dans l'évaluation de la perméabilité veineuse et le choix thérapeutique.

Transcranial Duplex scan is a relatively recent diagnostic tool with many unexplored clinical potentials. The authors insist on the role of transocular exploration, as a non-invasive substitute to angiography and discuss two patients with cavernous meningeal arteriovenous fistula, a benign but relatively uncommon disease. In the first patient, in whom symptoms recurred, Duplex scan was able to rule out thrombophlebitis and to show increased flow in the fistula, thus leading to proper treatment. In the second patient, the identification of a periorbital thrombophlebitis innocented the fistula and prompted anti-coagulation. We conclude that besides its diagnostic capabilities, Duplex scan may be helpful in selecting proper treatment and follow-up in specific neurovascular conditions.

[Value of sonography in prolonged neonatal jaundice. Findings in 13 cases]. / Place de l'échographie dans l'ictère néonatal prolongé. A propos de 13 cas.

BACKGROUND: Different conditions are associated with a prolonged cholestatic jaundice in the neonatal period: viral hepatitis, biliary atresia and choledocal cyst are the most frequent causes. Laboratory findings are necessary, although they do not permit an etiologic diagnosis in all cases. Serial ultrasonographic study could be proposed for the evaluation of biliary excretion before and after feeding, in order to differentiate between these three conditions. PATIENTS AND METHODS: Between February 1993 and January 1997, 13 newborns (seven girls and six boys) aged from 30 to 186 days, presented with jaundice and conjugated hyperbilirubinemia. They were evaluated by laboratory tests; serial ultrasonographic examinations were performed after 4 hours fasting then 1 and 2 hours after meal. RESULTS: The gallbladder (GB) was visualized in nine patients. In five of these patients, it contracted after feeding suggesting the diagnosis of neonatal hepatitis, that was confirmed by the clinical evolution. In three patients, the GB did not change in size and the diagnosis of biliary atresia was surgically proven. In one patient, a choledocal cyst was visualized and confirmed by surgery. The GB was not identified after 4 hours of fasting in four patients; biliary atresia was suspected and confirmed by surgery. CONCLUSION: Serial ultrasound of the GB is an easy and non-invasive method. It was useful in identifying those conditions requiring surgery in eight patients. We recommend its use as the initial method in the evaluation of neonatal jaundice before the other invasive methods.

[Aneurysm of the hepatic artery treated by embolization]. / Anévrisme de l'artère hépatique traité par embolisation.

The hepatic artery aneurysm represent 16 to 20% of visceral artery aneurysms. The man of 40 years of age is often affected. This aneurysm is often asymptomatic. The rupture menace its evolution and justify the treatment. Echo-doppler-color constitute a non invasive exam of choice for diagnosis. Embolisation has a more extent indications. A case is reported of an aneurysm of the hepatic artery treated with embolisation with review of the literature.