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    Biliary Atresia

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    RAGHU NATH KARMAKER
    This case presentation describes a 2.5 month old male infant with progressive jaundice, pale stool, and dark urine since birth. On examination, the patient was ill-looking and jaundiced with yellow discoloration of the mouth. The liver was enlarged but non-tender. The provisional diagnosis was biliary atresia, which was to be differentiated from neonatal hepatitis or choledochal cyst based on further investigation and imaging. The patient was scheduled to undergo the Kasai procedure or potential liver transplantation for treatment.

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    Biliary Atresia

    Uploaded by

    RAGHU NATH KARMAKER
    38 views24 pages
    This case presentation describes a 2.5 month old male infant with progressive jaundice, pale stool, and dark urine since birth. On examination, the patient was ill-looking and jaundiced with yellow discoloration of the mouth. The liver was enlarged but non-tender. The provisional diagnosis was biliary atresia, which was to be differentiated from neonatal hepatitis or choledochal cyst based on further investigation and imaging. The patient was scheduled to undergo the Kasai procedure or potential liver transplantation for treatment.

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    Biliary atresia

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    Biliary atresia

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    This case presentation describes a 2.5 month old male infant with progressive jaundice, pale stool, and dark urine since birth. On examination, the patient was ill-looking and jaundiced with yellow discoloration of the mouth. The liver was enlarged but non-tender. The provisional diagnosis was biliary atresia, which was to be differentiated from neonatal hepatitis or choledochal cyst based on further investigation and imaging. The patient was scheduled to undergo the Kasai procedure or potential liver transplantation for treatment.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    38 views24 pages

    Biliary Atresia

    Uploaded by

    RAGHU NATH KARMAKER
    This case presentation describes a 2.5 month old male infant with progressive jaundice, pale stool, and dark urine since birth. On examination, the patient was ill-looking and jaundiced with yellow discoloration of the mouth. The liver was enlarged but non-tender. The provisional diagnosis was biliary atresia, which was to be differentiated from neonatal hepatitis or choledochal cyst based on further investigation and imaging. The patient was scheduled to undergo the Kasai procedure or potential liver transplantation for treatment.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 24

    Long case presentation

    (Biliary Atresia)

    Dr. Sajal Debnath


    Phase-A resident
    Dept. of paediatric surgery
    MMCH
    Particulars of the patient
    • Name : Asif
    • Age : 2.5 months
    • Sex : Male
    • Religion : Islam
    • Address : Gouripur, Mymensingh
    • Date of admission : 20/09/23
    • Date of examination : 05/10/23
    Chief complaints
    • Yellow discoloration of eyes and skin since
    birth.
    • Persistent pale colored stool and dark colored
    urine since 07 days of age.
    History of present illness
    • According to the statement of the patient’s
    mother,he was born with yellow discoloration
    of both eye and skin which was progressive in
    nature. Mother also noticed persistent pale
    colored stool and dark colored urine since 7
    days of his life. Mother gave no history of poor
    feeding, vomiting,fever, itching and bleeding
    manifestation.
    History of past illness
    • The patient was admitted in paediatric dept.
    of MMCH 01 month back with the same
    complaints and treated conservatively. They
    are also advised some ivestigations on
    discharge but she couldn’t show any paper.
    Birth history
    • Antenatal history : She was not in regular ANC.
    • Natal history : he was delivered by normal
    vaginal delivery, birth weight 2.4kg.
    • Post natal history : uneventful.
    • Feeding history : exclusive breast feeding
    • Developmental history : age appropriate
    • Immunization history : only BCG vaccine was
    given.
    • Family history : the baby was the 3rd issue of
    the non consanguineous parents, parents are
    in good health, no family history of liver
    disease or same type of illness.
    • Socioeconomic history: His socioeconomic
    history is average.
    General examinations
    • Appearance : ill-looking.
    • Pallor : mildly pale
    • Jaundice : moderately icteric
    • Dehydration : absent
    • Edema : absent
    • Cyanosis : absent
    • Clubbing : absent
    • Koilonychia: absent.
    • Leuconychia : absent
    • Lymph node : not palpable
    • Anterior fontanel : open, normal
    • Skin survey : BCG mark present.
    Vital signs
    • Temp : 98°F
    • Pulse : 90b/min
    • Res. Rate : 24b/min
    • Length : 55cm
    • OFC : 35cm
    GIT
    • Mouth and oral cavity : yellowish
    discoloration.
    • Abdomen :
    • Inspection : shape is scaphoid in shape, flanks
    are not full,umbilicus centrally placed &
    inverted,no engorged vein,visible peristslsis or
    any scar mark. Hernial orifices are intact.
    • Palpation : abdomen is soft, non tender.
    Liver: liver is palpated, 5 cm from right costal
    margin and in mid-clavicular line, non-tender, firm in
    consistency, surface is smooth, margin is Sharp, upper
    border of liver dullness is at rt 4th intercostal space.
    Spleen: not palpable.
    • Percussion : tympanic, shifting dullness absent.
    • Auscultation : bowel sound present.

    Other systemic examination reveals no


    abnormality.
    Salient feature
    • Asif, a 2.5 months old male baby, 3rd issue of
    his non-consanguineous parents hailing from
    gouripur, mymensingh, got admitted with the
    complaints of progressive jaundice, passage of
    persistent pale stool and dark colored urine
    since 4th day of life. there was no history of
    poor feeding, vomiting, fever, itching and
    bleeding manifestation.
    • He was admitted in paediatric dept. Of MMCH
    01 month back with the same complaints and
    treated conservatively. They are also advised
    some investigation on discharge but she
    couldn’t show any paper. He was born NVD at
    term.
    • On general examination – he was ill looking,
    mildly pale, moderately icteric.
    • On systemic examination – mouth and oral
    cavity shows yellowish discoloration.
    • On palpation- liver is palpated 5 cm from right
    costal margin and in mid clavicular line. Liver is
    non-tender, firm in consistency, surface is
    • Smooth, margin is Sharp, upper border of liver
    dullness is at 4th intercostal space.

    • Other system examination reveals normal.


    Provisional diagnosis
    • Obstructive jaundice may be due to biliary
    atresia.
    Differential diagnosis
    • Neonatal hepatitis.
    • Choledochal cyst.
    Investigations
    • CBC with blood grouping
    • Liver function test
    • USG of HBS
    • HIDA scan
    Treatment

    • The Roux-en-Y hepatic Portoenterostomy


    procedure.(Kasai procedure).
    • Liver transplantation.

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