Biliary atresia: a clinical review
Rosselló, P.
Boletin de la Asociacion Medica de Puerto Rico 74(2): 20-23
1982
ISSN/ISBN: 0004-4849 PMID: 6958275 Document Number: 700912
We reviewed the cases of biliary atresia managed at the University and University Children Ilospitals during a recent 10 year period. Sixteen patients were identified from computer listings; of these 13 records were located and reviewed. The presenting signs and symptoms for these cases mere similar to those described in the literature. The hospital work-up routinely included bilirubin and liver function tests in all patients, but other more specific studies were only sporadically performed (T.O.R.C.H. titers, liver scan). There %sere no preoperative transcutaneous liver biopsies performed. The surgical treatment in cases with uncorrectable type of biliary atresia consisted of an exploratory laparotomy and liver biopsy, with a cholangiogram if possible. All patients with uncorrectable type of biliary atresia followed a documented downhill course with eventual death. The age at operation was relatively late, occupying at an average of 15 weeks. In view of present evidence that biliary drainage, a jaundice-free state, and possible long term survival are attained in a significant percentage of babies with uncorrectable biliary atresia, and in view of the clear correlation between successful drainage and early operation, it is recommended that infants with jaundice unresolved after one month, undergo an expeditious diagnostic work-up and subsequent early reconstruction with a Kasai type procedure before the age of 8 weeks.
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