Title : BILIARY ATRESIA
 
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.
 
Question : Should this child undergo Kasai surgery_?
 
Expert Opinion : 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.
 
Funding : None
 
Conflict of Interest : None
 
DOI No. : 10.7199/ped.oncall.2013.63
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.