>>With imaging, they see them in plenty of adults.
Have you read "The House of God" which is a purportedly satirical but actually truthful portrayal of healthcare. The 10th Law of the House of God was:
IF YOU DON'T TAKE A TEMPERATURE, YOU CAN'T FIND A FEVER.
Which actually was an exhortation NOT to take a temperature in some patients because they always have a fever and once you find it, you have to investigate it and then the patient gets sick. ;-)
Law 12 was
IF THE RADIOLOGY RESIDENT AND THE MEDICAL STUDENT BOTH SEE A LESION ON THE CHEST X-RAY, THERE CAN BE NO LESION THERE.
And Law 13 was
THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.
Your Chari malformation is best treated according to these Laws. ;-)
"... They ne'er cared for us
yet: suffer us to famish, and their store-houses
crammed with grain; make edicts for usury, to
support usurers; repeal daily any wholesome act
established against the rich, and provide more
piercing statutes daily, to chain up and restrain
the poor. If the wars eat us not up, they will; and
there's all the love they bear us."
-- Shakespeare: Coriolanus, Act 1, scene 1
