fetal cholelithiasis

Fetal cholelithiasis refers to formation of gallstones in utero.

Epidemiology

There occurrence is thought to be relatively common and is estimated at 1 in 300 pregnancies. They are almost always seen in the 3 trimester . There may be slightly greater male predilection .

Pathology

Associations

hemolytic conditions of the newborn
maternal hemolytic anemia(s)

Radiographic features

Antenatal ultrasound

They may be seen as cluster of minute echogenic juxta-hepatic foci at the expected position of the gallbladder. Shadowing as well as comet tail artifacts may also be seen.

In the context of gallbladder sludge, the gallbladder may be diffusely echogenic. It may be sometimes difficult, if not impossible, to distinguish true sludge from multiple small stones .

Prognosis

In most cases, they are not thought to be of much concern with most resolving within the 1year of life.

Differential diagnosis

For calcific foci closely abutting the liver consider

juxta-hepatic calcification from meconium peritonitis
in utero fetal infection(s)
in utero calcified hemangioma of the liver close to the periphery towards the gallbladder