Characterisation of computed tomography angiography findings in paediatric patients with heterotaxy.

BACKGROUND: Heterotaxy refers to the abnormal arrangement of organs across the left-right axis and is typically associated with complex cardiovascular malformations. OBJECTIVE: To characterise the range of cardiac and extracardiac CT angiography findings in children with heterotaxy using the latest nomenclature consensus and to compare the different types of isomerism. MATERIALS AND METHODS: We retrospectively analysed the data of 64 consecutive paediatric patients referred to our tertiary paediatric cardiovascular centre who underwent CT angiography for the evaluation of known or suspected heterotaxy within a 52-month period. RESULTS: Right atrial isomerism was identified in 44 (69%) children, while left atrial isomerism was identified in 18 (28%) children. Atrial appendage anatomy and situs could not be determined in 2 children (3%). Associated heart defects included complete atrioventricular canal (CAVC) in 51 (80%) children, total anomalous pulmonary venous return in 43 (67%) and pulmonary atresia in 23 (36%). The bronchial branching pattern corresponded to atrial appendage morphology in all children except in the two in whom atrial appendage morphology could not be defined. In children with right atrial isomerism, the most common associated abnormalities were CAVC (n=41, 93%) and asplenia (n=34, 77%), while in those with left atrial isomerism, the most common associated abnormalities were polysplenia (n=17, 94%) and an interrupted inferior vena cava with azygos continuation (n=15, 83%). CONCLUSION: CT angiography provides useful cardiovascular and extracardiac data on heterotaxy, which frequently involves a pattern of side-related findings but has great anatomical variability.

[Acute pancreatitis in childhood by choledocal stone in a choledocal cyst. Case report]. / Pancreatitis en la infancia por litiasis coledociana en quiste de colédoco complicado. Reporte de caso.

Acute pancreatitis is a known complication of choledochal cysts. It is associated with changes in the biliopancreatic junction and with intra-cystic gallstones. We describe a case of pancreatitis and biliary obstruction caused by choledochal cyst type IVa complicated with obstruction by biliary stones in a 2 year old infant.

Pancreatitis en la infancia por litiasis coledociana en quiste de colédoco complicado. Reporte de caso / Acute pancreatitis in childhood by choledocal stone in a choledocal cyst. Case report

La pancreatitis aguda es una complicación evolutiva de los quistes de colédoco, se asocia a alteraciones de la unión biliopancreática y litiasis intra-quística. Se describe un caso de pancreatitis y obstrucción de vía biliar por quiste de colédoco tipo IVa complicado por cálculos enclavados, en infante de 2 años...

Acute pancreatitis is a known complication of choledochal cysts. It is associated with changes in the biliopancreatic junction and with intra-cystic gallstones. We describe a case of pancreatitis and biliary obstruction caused by choledochal cyst type Iva complicated with obstruction by biliary stones in a 2 year old infant...