Biliary atresia

[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]

[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]

[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]

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"

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[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]

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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? ​

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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]

[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 abs…

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​

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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]

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

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