Biliary atresia Latest Topics

12/7/2026

Sun, 12 Jul 2026 10:07:47 +0000

[size=6]A 50-day-old infant has conjugated hyperbilirubinemia, mild transaminitis, and acholic stool. Ultrasonography demonstrated an absent gallbladder. A blood sample was sent out for MMP-7 yesterday and results are pending. What is the next best step in management?

a Await MMP-7 results

b Operative cholangiogram

c Liver transplant

d Duodenal intubation[/size]

5/4/2026

Sun, 05 Apr 2026 11:41:25 +0000

[size=6]A three-week-old infant presents with direct hyperbilirubinemia, acholic stools and jaundice. Indocyanine green is administered intravenously but it was not detected in the child’s diaper even after 48 hours. What is the best next step in this child’s management?

a magnetic resonance cholangio pancreatography (MRCP)

b gallbladder ultrasound

c intraoperative cholangiogram

d Kasai portoenterostomy[/size]

30/11/2025

Sun, 30 Nov 2025 14:07:07 +0000

[size=6]An 11-month-old baby who underwent Kasai portoenterostomy as an 8-week old presents with her fourth episode of cholangitis. MRCP scan shows a 1.5 cm x 1 cm anechoic fluid collection close to the Roux limb (Figures below). A smaller fluid collection was also seen in the left lobe of the liver.

[/size]

[center][size=6][/size][/center]

[size=6]

These structures are likely

a Cystic biliary atresia

b Lymphatic collections

c Small abscesses

d Bile lakes[/size]

During IOC for suspected Biliary atresia

Thu, 13 Mar 2025 06:14:10 +0000

Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

"Trendelenburg positioning may also augment contrast delivery to the intrahepatic bile ducts if initial images are equivocal, and administration of intravenous glucagon may improve drainage of contrast into the duodenum if such flow is not initially evident"

dissection margin in Kasai portoenterostomy

Thu, 11 Jan 2024 16:23:06 +0000

Diagnosis of biliary atresia

Fri, 14 May 2021 19:46:54 +0000

Diagnostic Lap in Biliary Atresia

Mon, 09 Aug 2021 17:30:22 +0000

see video link in second post

11/8/2024

Sun, 11 Aug 2024 11:07:48 +0000

[size=20px]You are asked to see a four-week old female with direct hyperbilirubinemia. Ultrasound suggests a small collapsed gallbladder and HIDA study shows hepatic uptake without secretion. Studies for metabolic and infectious diseases were sent off today and final results should be back in 7-10 days.

What is the best next step in managing this child with jaundice?

A wait for metabolic and infection studies.

B ERCP and stent placement

C cholangiogram and liver biopsy

D liver transplant

E MRCP[/size]

Early prediction of the need for liver transplantation in biliary atresia patients

Sat, 06 Jul 2024 07:43:45 +0000

Coagulopathy in biliary atresia patients

Mon, 27 May 2024 06:20:44 +0000

beware of cystic biliary atresia Variant

Mon, 15 Jan 2024 17:53:34 +0000

DD & management of neonatal jaundice

Fri, 12 Jan 2024 14:31:08 +0000

During Kasai portoenterostomy

Sat, 15 May 2021 14:12:37 +0000

stool color cards for parents of biliary atresia patients

Fri, 12 Jan 2024 14:29:01 +0000

Regarding Kasai portoenterostomy anastomosis

Thu, 14 Dec 2023 17:42:55 +0000

cbclips Episode 38

Thu, 02 Feb 2023 17:51:08 +0000

A 56-day old boy underwent a successful Kasai procedure for biliary atresia with complete clearance of jaundice at 5 months of age.

At 18 months of age, he starts to develop episodes of cholangitis that recur every few weeks. Each episode responds well to antibiotics, and bilirubin normalizes between episodes.

US, MRCP, and percutaneous cholangiogram images are shown below.

How would you manage this patient?

Regarding technique of lap kasai operation

Thu, 14 Sep 2023 16:10:00 +0000

Laparoscopic Kasai

Thu, 03 Jun 2021 17:21:11 +0000

see video link in second post

4/6/2023

Sun, 04 Jun 2023 13:39:31 +0000

You are asked to consult on a four-week old infant girl with acholic stools, jaundice and serum direct bilirubin of 5 mg/dL. Your evaluation also reveals abnormal facies with deep set eyes and a broad forehead, a cardiac murmur and a thoracic butterfly vertebral anomaly. Liver ultrasound is normal and HIDA scan shows radionuclide uptake into the liver but no excretion into the intestine at twenty-four hours. Which of the following is the most common gene mutation identified during genetic testing?

[center][/center]

[size=20px]A CFTR

B JAG1

C ATP8B1

D NOTCH1

E SERPINA1[/size]

Biliary atresia

Sun, 29 Nov 2020 17:00:34 +0000

[size=20px]A 5 week old term infant is jaundiced and has acholic stools. Her total serum bilinubin is 9 mg/dl (conjugated 7 mg/dl). Ultrasonography shows a small gallbladder, with no choledochal cyst or other abnormalities. Hepatobiliary (HIDA) scan after five days of phenobarbital treatment shows radionuclide uptake into the liver, but no excretion into the intestine at twenty-four hours. At operative exploration, a small gallbladder is identified. Aspiration of the gall bladder yields a small amount of green fluid. An operative cholangiogram shows free passage of contrast through the common hepatic duct into the duodenum, small right and left extrahepatic ducts, and absence of intrahepatic filling. The most appropriate management is :

A. biopsy of the liver and closure of the abdomen

B. resection of the extrahepatic ducts and reconstruction with hepatoportoenterostomy (Kasai procedure)

C. cholecystoportoenterostomy (gallbladder Kasai procedure)

D. irrigation of the extrahepatic ducts through gallbladder with 5% N-acetyleysteine

E. transduodenal sphincteroplasty[/size]

7/5/2023

Sun, 07 May 2023 15:44:09 +0000

You are asked to assess a 7-week-old infant with a history of jaundice and acholic stools. Serum total and direct bilirubin and gamma-glutamyl transferase (GGT) are elevated. Serum α-1-antitrypsin and thyroid testing are normal. Abdominal ultrasound identifies a small, contracted gallbladder. What is the next best step in the management of this infant?

A Hepatobiliary iminodiacetic acid (HIDA) scan

B Percutaneous liver biopsy

C Endoscopic Retrograde Cholangiopancreatography (ERCP)

D Magnetic Resonance Cholangiopancreatography (MRCP)

E Intra-operative cholangiogram and possible Kasai procedure

Biliary Atresia with Dr. Greg Tiao

Tue, 24 Jan 2023 07:50:16 +0000

see video link in second post

1/5/2022

Sun, 01 May 2022 13:17:06 +0000

A neonate 25 days old with a prolonged episode of jaundice from birth has a spine radiograph that shows an abnormal segmentation of the vertebral bodies at D8 level. An ultrasound scan shows a collapsed gallbladder and 99mTc-DISIDA scintigraphy shows tracer in the bowel at 24 hours. What is the likely diagnosis?

[size=20px]a Alagille’s syndrome

b biliary atresia (type I)

c neonatal jaundice

d biliary atresia (type III)

e Caroli’s disease[/size]

Error traps and culture of safety in biliary atresia

Tue, 15 Dec 2020 16:34:34 +0000

Any one want a high quality PDF of this chart, post in this thread, use a personalized picture as an avatar, and have six threads in the forums, I will send it to you in a private message

Edit: Available without restrictions

Pre-Operative Biliary Atresia Algorithm

Thu, 23 Dec 2021 10:18:44 +0000