BILIARY ATRESIA
Dr Ira Shah
Medical Sciences Department, Pediatric Oncall, Mumbai, India
Address for Correspondence: Dr Ira Shah, 1, B St Francis Road, Vile Parle {W}, Mumbai 400056, India.
Clinical Problem :
A 5 months old girl presented with jaundice, high coloured urine and clay coloured stools since birth. There was no fever or rash in mother during pregnancy. On examination, child was well grown, had jaundice with hepatomegaly with leafy borders and nodular liver. Investigations were suggestive of biliary atresia.
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Should this child undergo Kasai surgery_?
Discussion :
Success of Kasai’s portoenterostomy depends on several factors namely:
• Age of surgery {success is better if operated by 8-12 weeks of age}
• Size of bile ducts at porta {sizes Less than 200 microns have poor prognosis}
• Skill of the surgeon
• Condition of the liver {an already cirrhotic liver has poor prognosis}
In this child, the age is already 20 weeks, the liver is already cirrhotic thus Kasai portoenterostomy will not be successful. Infact, the treatment of choice in this child would be liver transplant.
| Correct Answers : |  55% |
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