Wednesday, September 12, 2007

A case of Biliary Atresia

A boy of 3 months presented with persistent jaundice from 3 days o life, pale color stool , high color urine and occasional vomiting.

On examination he is found nutritionally compromised, moderately jaundiced, has hepatosplenomegaly but no ascites.

On investigation, Serum bilirubin- was 8.8 mg/dl( direct -3.6mg/dl, indirect- 5.2 mg/dl)
SGPT (ALT)-105 U/L, Serum Alkaline phosphatase- 970 U/L, prothrombin time -23 sec against control of 15 sec.

USG shows non visualized gall bladder and common bile duct

HIDA scan shows radiotracer concentration in the liver in early images. No radiotracer concentration is seen in the gall bladder region and in the intestine even after 2 and ½ hours .

The case is diagnosed as Biliary Atresia

Our surgical colleagues were consulted for surgical management of the patient.



Dr. Rajasekar said...

This child has features of liver failure and may not benefit from bypass operations like Kasai operation. He needs a liver transplant.

badrud doza said...

Thanks Dr. Rajaseker for your comment.
That's true. The patient would need liver transplant.
Would you go straight for liver transplant or do Kasai as an intermediary operation?

How about the liver transplant in peadiatric age group in India? Pease add few links of available centres in India for liver transplatation.

Dr. Rajasekar said...

I generally do not carryout Kasai operation on babies beyond 60 days of birth, as majorty would have significant and irreversible liver pathology. However if synthetic function of the kiver is normal and there is no PHT or ascites one can perform Kasai upto 3 months of age, just to buy time and growth. I am a trained pediatric and adult liver transplant surgeon who established the first program in India. I will be able to help children in Bangladesh who may need liver transplant at a very affordable cost. I am creating a new center in Chennai, where the low cost transplants will be carried out. Do let me know if I can help any of your patients.
My site is
- Show quoted text -

badrud doza said...

Thanks for the information.

Hope said...

i was born with billiary tresia and have been hospitalized a number of times. about three years ago it started getting bad and i had to be hospitalized about every three months. im twenty years old and the doctors where i live dont know how to fix it. all they do is drug me up for about a week to keep me from pain and do iv antibiotics. is there anything to do or am i just going to have to be hospitalized everytime it acts up for the rest of my life.