https://wikem.org/w/index.php?action=history&feed=atom&title=Biliary_atresia%2FenBiliary atresia/en - Revision history2026-04-19T19:05:21ZRevision history for this page on the wikiMediaWiki 1.38.2https://wikem.org/w/index.php?title=Biliary_atresia/en&diff=380324&oldid=prevFuzzyBot: Updating to match new version of source page2026-01-06T21:42:54Z<p>Updating to match new version of source page</p>
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==Background==<br />
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[[File:Bilatresia.jpg|thumb|Intraoperative view of complete extrahepatic biliary atresia.]]<br />
*Rare, but leading indication for liver transplantation in children<ref>Mieli-Vergani G1, Vergani D. Biliary atresia. Semin Immunopathol. 2009 Sep;31(3):371-81. PMID: 19533128</ref><br />
*Exact etiology unclear, but inflammation leads to destruction of intra/extrahepatic bile ducts<br />
*Prognosis ''significantly'' improved by early diagnosis<ref>Wadhwani SI1, Turmelle YP, Nagy R, Lowell J, Dillon P, Shepherd RW. Prolonged neonatal jaundice and the diagnosis of biliary atresia: a single-center analysis of trends in age at diagnosis and outcomes. Pediatrics. 2008 May;121(5):e1438-40. PMID: 18443020</ref><br />
*Two forms:<br />
**Peri/postnatal (90% of cases), possibly related to infection<br />
**Fetal/embryonic (10%)<br />
***Often with other associated malformations (e.g [[Special:MyLanguage/congenital heart disease|congenital heart disease]], polysplenia or [[Special:MyLanguage/asplenic|asplenia]], malrotation, situs inversus, portal vein or hepatic artery malformations)<br />
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{{Gallbladder disease types}}<br />
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==Clinical Features==<br />
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*Presentation often subtle<br />
*[[Special:MyLanguage/Neonatal jaundice|Neonatal jaundice]]<br />
**High index of suspicion for jaundice that persists beyond 1st week of life or includes conjugated [[Special:MyLanguage/hyperbilirubinemia|hyperbilirubinemia]]<br />
*[[Special:MyLanguage/Hepatomegaly|Hepatomegaly]]<br />
*Acholic stools<br />
*Dark urine<br />
*Late findings: [[Special:MyLanguage/failure to thrive (peds)|failure to thrive]], [[Special:MyLanguage/ascites|ascites]], splenomegaly<br />
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==Differential Diagnosis==<br />
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{{Neonatal jaundice differential diagnosis}}<br />
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==Evaluation==<br />
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[[File:PMC3016234 247 2010 1858 Fig3 HTML.png|thumb|Persistent neonatal cholestasis and biopsy-proven biliary atresia in a 1.5-month-old boy. US shows the triangular cord sign (arrow in a) and increased diameter of the hepatic artery (27 mm, arrow in b)]]<br />
*Evaluate for other causes of [[Special:MyLanguage/neonatal jaundice|neonatal jaundice]], [[Special:MyLanguage/liver failure|liver failure]]<br />
*Assess for complications of liver disease (e.g. [[Special:MyLanguage/coagulopathy|coagulopathy]])<br />
*[[Special:MyLanguage/RUQ US|RUQ US]] to screen for other abnormalities (though cannot definitively diagnose biliary atresia<ref>https://www.niddk.nih.gov/health-information/liver-disease/biliary-atresia/diagnosis</ref>)<br />
*Definitive diagnosis made by biopsy or surgical pathology<br />
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==Management==<br />
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*Surgery<br />
**Kasai procedure or [[Special:MyLanguage/liver transplant|liver transplant]] for those who fail kasai<br />
*[[Special:MyLanguage/Coagulopathy|Coagulopathy]] (if present) responds to [[Special:MyLanguage/vitamin K|vitamin K]] supplementation<br />
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==Disposition==<br />
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*Admit<br />
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==See Also==<br />
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*[[Special:MyLanguage/Neonatal jaundice|Neonatal jaundice]]<br />
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==External Links==<br />
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==References==<br />
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https://pedemmorsels.com/biliary-atresia/<br />
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[[Category:Pediatrics]] [[Category:GI]] [[Category:Surgery]]</div>FuzzyBot