Learning objectives
To explore the definition of biliar atresia disease.
To describe the radiological patterns of the disease.
To present structural malformations associated to biliary atresia.
To provide key points to the differential diagnosis.
To propose a standard report with the components of interest for the Pediatric and Hepatology group.
Background
Biliary atresia is a rare disorder in children that affects the biliary tract with progressive fibrosing obstruction and liver failure.
Early detection in children with persisting jaundice can improve on the quality of life and prevent a poor outcome.
The diagnosis is based on laboratory test,
imaging findings and liver biopsy.
Current management includes multidisciplinary care teams,
Kasai portoenterostomy and prevention of cholangitis,
but in cases of failure and end-stage cirrhosis a liver trasplantation can be taken into consideration.
Findings and procedure details
The pathogenesis of Biliary Atresia appears to be multifactorial,
but the cause is not understood yet.
Congenital malformation such heterotaxia,
spleen anomalies (polysplenia,
asplenia),
intestinal malrotation,
and preduodenal portal vein,
has been reported in 20% of the cases with biliary atresia.
It has also been associated with prenatal exposure to viruses (Cytomegalovirus and rotavirus).
We present a review of the disease,
the imaging findings and the current management.
We include patients with diagnosis of biliary atresia confirmed by biopsy in our hospital.
KASAI CLASSIFICATION (Figure...
Conclusion
It is important for the radiologist to understand the pathophysiological events present in the development of the biliary atresia and the imaging findings in order to communicate effectively the findings to the pediatric care team.
An early diagnosis can improve the quality of live and the survival rate of this patients.
References
Feldman AG1,Mack CL.Biliary Atresia: Clinical Lessons Learned.J Pediatr Gastroenterol Nutr.2015 Aug;61(2):167-75.
doi: 10.1097/MPG.0000000000000755.
Nakamura H,Murase N,Koga H3,Cazares JLane GJ3,Uchida H,Yamataka A.Classification ofbiliary atresiain the laparoscopic era.Pediatr Surg Int.2016 Dec;32(12):1209-1212.
Epub 2016 Sep 21.
Kasai M,
Sawaguchi M,
Akiyama T et al (1976) A proposal of new classification of biliary atresia.
J Jpn Soc Pediatr Surg 12:327–331
Superina R,
Magee JC,
Brandt ML,
Healey PJ,
Tiao G,
Ryckman F et al (2011) The anatomic pattern of biliary atresia identified at time of Kasai hepatoportoenterostomy and early...