Fetal gallstones in a contracted gallbladder: potential to simulate hepatic or peritoneal calcification.

When discovered during antenatal sonography, fetal gallstones generally are considered benign and inconsequential.1–7 The identity of the stones usually is readily apparent, because these echogenic foci often are found within a gallbladder recognizable by a characteristic location and configuration. If the gallbladder is contracted, however, the echogenic foci may not be perceived as gallstones and therefore could be misdiagnosed as other, more ominous entities, such as liver or peritoneal calcifications. We describe the sonographic features in two fetuses with gallstones in whom the origin of the stones was not apparent on initial images because the gallbladder was incompletely distended, and we suggest an approach to a correct diagnosis. CASE 1