MA Shuai, GONG Rui, ZHU Kai
Department of radiology & imaging
Jiangsu University, Zhenjiang


A 29 year old primi came for routine prenatal
ultrasound examination, when calculi in the foetal
gall bladder were detected. No congenital anomaly
was detected. This is first case report of the
sonographic findings the isolated foetal gallbladder calculi
without pre existing biliary disease or associated congenital anomaly in Zhenjiang.
Isolated foetal gallstones are rare findings on prenatal ultrasound examinations. Most resolve spontaneously prior to delivery. Hejne et al.2 reported the largest series of foetal gallstones which included 26 foetuses.

Case reports
A 29-year-old 1st Gravida patient was referred to
private diagnostic clinic for routine foetal ultrasound.
Foetal biometry was consistent with 36 weeks of
gestation. Multiple echogenic substances were
detected within the foetal gallbladder lumen.
Followed by high resolution real time mode and 3D ultrasound done for primi patient and isolated gallstones proved with better sensitivity and confidence ratio.
Foetal gallstones are a very rare finding on prenatal
ultrasound1,2,3. Sheiner and colleagues.4 reported
the largest series of fetal gallstones in whom gall bladder sludge or stones were observed in the third trimester of pregnancy.
In 53% of those with follow up, the findings
resolved asymptomatically. In 3 foetuses, it persists
in the childhood but the children remain
asymptomatic. .
Hepatic calcifications are one of the common
differential diagnosis of fetal gallstones.
There are two theories in the formation of foetal
gallstones: production of bilirubin from breakdown
of haemoglobin in placental haematoma and
increased cholesterol secretions and suppression
bile acid synthesis caused by oestrogens.
The natural history of foetal gallstones is different
from that of adults. Gallstones in adults grow
slowly in many years at about 1 to 2 mm per year,
before clinical symptoms appear. However, gall
stones may dissolve or pass into the small gut6,7.
Most gallstones are asymptomatic. Isolated Foetal
gallstones may have a tendency to form in the third
trimester of pregnancy7.

In fact, cholelithiasis is an unusual finding in the
first year of life, being more frequent in patients
with bile duct pathology, with an incidence around
5% .But in this particular case, as well as the literature
reported, ultrasound showed no biliary tract
abnormality and neither the mothers nor the
patients had clinical or laboratory findings with
liver or biliary diseases.

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