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What Does The Following Sonography Test Report Indicate?
Question: Hi Doctor,
I have one question regarding birthmark of new born baby. My baby boy is about 2 month old and having strawberry color mark and green/bluish color swelling around it. Doctor suggested us for sonography/PT-INR test/2 D echo test. Below is the report
Sonography:
USG-Swelling left chest wall examination report says
"A well defined hyperechronic lesion measuring 3.0 cm * 0.6 cm is seen in left antero-lateral chest wall. it shows cystic areas within.
Color doppler examination shows the lesion to be fairly vascular with high velocity blood flow seen in the lesion within a feeder vessel. These findings are suggestive of Arterio venous Malformation"
PT/INR:
PT-13 seconds
Prothombin Index-100%
Prothombin Ratio-1
INR-1
ISI value of Prothombin used is 1
2 D echo not done yet.
Our doctor suggested that if 2 D echo looks good then he will start some medicine & injection which we need to give after every 21 days.
Could you please provide me suggestion on this.
I have one question regarding birthmark of new born baby. My baby boy is about 2 month old and having strawberry color mark and green/bluish color swelling around it. Doctor suggested us for sonography/PT-INR test/2 D echo test. Below is the report
Sonography:
USG-Swelling left chest wall examination report says
"A well defined hyperechronic lesion measuring 3.0 cm * 0.6 cm is seen in left antero-lateral chest wall. it shows cystic areas within.
Color doppler examination shows the lesion to be fairly vascular with high velocity blood flow seen in the lesion within a feeder vessel. These findings are suggestive of Arterio venous Malformation"
PT/INR:
PT-13 seconds
Prothombin Index-100%
Prothombin Ratio-1
INR-1
ISI value of Prothombin used is 1
2 D echo not done yet.
Our doctor suggested that if 2 D echo looks good then he will start some medicine & injection which we need to give after every 21 days.
Could you please provide me suggestion on this.
Brief Answer:
I agree with your doctor according to color doppler report
Detailed Answer:
Hello
Thanks for asking on this platform
I have gone through the reports and do understand your concern well.
The most common cause of such swelling in this age is Hemangioma (a benign tumor of infancy) and in most of the cases improves over a period of time.
Arteriovenous malformation is not much common.And this occur due to abnormal connection between the vein and artery.
These lesions are not common in skin.
But the color doppler report shows increased blood flow which is a feature of malformations not common in hemangioma.Some physician mistakenly call all vascular malformation as arteriovenous malformation.
Prothrombin test is done for coagulation abnormality.Raised prothrombin time can be found in large vascular lesions.It is absolutely normal in your case.
Giving steroid injection,propranolol or laser therapy helps in improving the lesion.
Echo is usually done to see the ejection fraction (contractility of heart).
As you have mentioned the size is 3 cm and if there is no ulceration,bleeding or any other significant complain you may even wait for its spontaneous resolution.
I would suggest you to discuss the treatment modality and it's outcome with your doctor and then take the decision accordingly.
I shall be glad to answer if you have any more query
Regards
I agree with your doctor according to color doppler report
Detailed Answer:
Hello
Thanks for asking on this platform
I have gone through the reports and do understand your concern well.
The most common cause of such swelling in this age is Hemangioma (a benign tumor of infancy) and in most of the cases improves over a period of time.
Arteriovenous malformation is not much common.And this occur due to abnormal connection between the vein and artery.
These lesions are not common in skin.
But the color doppler report shows increased blood flow which is a feature of malformations not common in hemangioma.Some physician mistakenly call all vascular malformation as arteriovenous malformation.
Prothrombin test is done for coagulation abnormality.Raised prothrombin time can be found in large vascular lesions.It is absolutely normal in your case.
Giving steroid injection,propranolol or laser therapy helps in improving the lesion.
Echo is usually done to see the ejection fraction (contractility of heart).
As you have mentioned the size is 3 cm and if there is no ulceration,bleeding or any other significant complain you may even wait for its spontaneous resolution.
I would suggest you to discuss the treatment modality and it's outcome with your doctor and then take the decision accordingly.
I shall be glad to answer if you have any more query
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor for your reply. So is this a case of AVM? I have also attached the baby's image/all reports where the swelling is.
My baby is not having any other problem, he behaving like normal baby i.e.smiling/eye co-ordination etc.One thing is that from last 15 days he is passing green color loose stool with bubbles, doctor also given medicineVizylac and Zinc dry powder for suspension(Z&D) on that and we are giving to him. I am afraid because he is too small and we are doing such test. Just wanted to know if 2D echo looks good and if we started those injection & medicine does it have any side effect? and does this swelling will completely gone after this treatment. I know its difficult to tell you what will happen in future but as per your experience please advise.
My baby is not having any other problem, he behaving like normal baby i.e.smiling/eye co-ordination etc.One thing is that from last 15 days he is passing green color loose stool with bubbles, doctor also given medicineVizylac and Zinc dry powder for suspension(Z&D) on that and we are giving to him. I am afraid because he is too small and we are doing such test. Just wanted to know if 2D echo looks good and if we started those injection & medicine does it have any side effect? and does this swelling will completely gone after this treatment. I know its difficult to tell you what will happen in future but as per your experience please advise.
Brief Answer:
for better assessment consult a plastic surgeon
Detailed Answer:
Thanks for follow up
I have seen the image.Frankly speaking by seeing the image only it is difficult to comment whether it is Hemangioma or arteriovenous malformation (AVM).The color doppler report suggests that it is AVM.
Now even in uncomplicated AVM intially watchful observation can be done.
I want to assure you that these investigations like color doppler,2D Echo and prothrombin test are not at all harmful.
Coming to loose stool,this is very common in early infancy and need to be managed conservatively (frequent feeds to maintain proper hydration,zinc and probiotics).Apart from this check whether mother is taking anything unusual in her diet if baby is breast fed.
After treatment there can be residual hyperpigmentation of skin or lesion may recur.
I would like to get an expert opinion from a plastic surgeon regarding further management.
Regards
for better assessment consult a plastic surgeon
Detailed Answer:
Thanks for follow up
I have seen the image.Frankly speaking by seeing the image only it is difficult to comment whether it is Hemangioma or arteriovenous malformation (AVM).The color doppler report suggests that it is AVM.
Now even in uncomplicated AVM intially watchful observation can be done.
I want to assure you that these investigations like color doppler,2D Echo and prothrombin test are not at all harmful.
Coming to loose stool,this is very common in early infancy and need to be managed conservatively (frequent feeds to maintain proper hydration,zinc and probiotics).Apart from this check whether mother is taking anything unusual in her diet if baby is breast fed.
After treatment there can be residual hyperpigmentation of skin or lesion may recur.
I would like to get an expert opinion from a plastic surgeon regarding further management.
Regards
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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