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December 1995

Radiological Case of the Month

Author Affiliations

From the Department of Pediatrics, Neonatology Section (Drs Rehan and Fajardo) and the Department of Radiology (Dr Greenberg), Health Sciences Centre, Winnipeg, Manitoba.

Arch Pediatr Adolesc Med. 1995;149(12):1389-1390. doi:10.1001/archpedi.1995.02170250095016

A 3-KG female infant was delivered by cesarean section after an ultrasound scan at 38 weeks' gestation had shown a hepatic mass. Apgar scores were 4 and 7 at 1 and 5 minutes, respectively. She was immediately in respiratory distress and mild cardiac failure and required assisted ventilation, diuretics, and digitalis. Her initial complete blood count was hemoglobin, 111 g/L, white blood cell count, 9 × 109/L; platelets, 66 × 109/L; prothrombin time, 19 seconds (normal, 10.9 seconds); and partial thromboplastin time, 61 seconds. Abdominal examination revealed a liver palpable 6 cm below the costal margin. The examiner did not detect a bruit over the liver. The pulse was irregular, the precordium was hyperdynamic, and there was a grade 3/6 systolic murmur and a diastolic rumble heard over the cardiac apex. An electrocardiogram showed atrial flutter with a varying degree of heart block. Cardioversion was undertaken

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