Age: 6 weeks (born at 24 weeks)
Indication: Direct hyperbilirubinemia
Pneumatosis and portal venous gas
Branching linear echogenic foci throughout the liver with a peripheral predominance, concerning for portal venous gas. Thickened, echogenic bowel wall in the right upper quadrant, concerning for pneumatosis. Together, these findings are highly concerning for bowel ischemia. Recommend surgery consultation.
Gallbladder is visualized but is decompressed. These findings are not consistent with biliary atresia.
Liver is otherwise normal in size and appearance with no biliary duct dilation.
Increased right renal cortical echogenicity, which can be seen with medical renal disease. No hydronephrosis.