Radiological Case of the Month

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