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Biliary Atresia : Overview

What Is Biliary Atresia?

Biliary atresia may be a 
food poisoning during which the biliary system is closed or absent. The biliary system is that the network of small tubular structures and ducts that drain bile from the liver to the tiny intestine, where it helps the digestive process. Bile may be a liquid secreted by liver cells, made from cholesterol, bile salts and waste products (including bilirubin). Biliary atresia progressively destroys the bile ducts that carry bile from the liver to the intestine, beginning outside the liver and later affecting bile ducts inside the liver. The damaged ducts prevent the draining of bile from the liver; as a result, bile trapped inside the liver causes damage and scarring which will cause cirrhosis.

As the liver becomes scarred, it presses against the walls of the veins. This constricts the veins and blood cannot undergo 
them properly. The result's malignant hypertension (high vital sign within the portal vein).
This birth defect begins to progress very soon after birth. In its commonest form, extrahepatic biliary atresia, ducts outside the liver are affected first.

Although it's 
relatively rare (occurring in 1 out of each 10,000 live births), biliary atresia is that the commonest disease that needs transplantation. on the average , there's one case of biliary atresia out of each 15,000 live births. It occurs slightly more often in females than in males (1.4:1), and affects children of all races. within the us , approximately 300 new cases of biliary atresia in infants are diagnosed annually.

The explanation for 
biliary atresia isn't known. Researchers believe that auto-immune mechanisms could also be partly responsible; recent research suggests that biliary atresia might be triggered by a virus infection in susceptible infants. it's also thought that there are two sorts of biliary atresia: Embryonic (fetal) and perinatal. The perinatal type is usually related to a later onset of jaundice, and should be caused by environmental factors.

What is known surely is that biliary atresia affects only newborns; it's not hereditary; it's not contagious; and it's not preventable. Biliary atresia isn't caused by anything the mother did during pregnancy.


Biliary Atresia Symptoms in Children

Symptoms of biliary atresia usually begin to seem 
between two and 6 weeks after birth, and include:


·       Jaundice (a yellow appearance of the skin and whites of the eyes) that doesn't improve within one to 2 weeks

·       Dark yellow or brown urine, thanks to excessive bilirubin within the bloodstream that passes to the kidneys

·       Pale or clay-colored (acholic) stools, a sign that little or no or no bile (which gives bowel movements their normal color) is reaching the intestine

·       Enlarged liver that feels harder than normal, enlarged spleen

·       Poor weight gain


Biliary Atresia Diagnosis

Because early biliary atresia diagnosis of this disease is vital 
for successful treatment, infants who are jaundiced after four weeks aged are usually evaluated for biliary atresia. The baby's physician may recommend some or all of those tests to verify or rule out the diagnosis:


·       Blood tests that measure liver function and blood coagulation factors, also as a CBC (complete blood count)

·       Liver biopsy (bi-op-see)

·       Ultrasound, to spot any clear abnormalities within the liver or in other organs

·       A nuclear scan, which tracks bile be due the liver

·       Sometimes, exploratory surgery is performed to look at the liver and bile ducts


Biliary Atresia Treatment

Some complications of biliary atresia are often 
treated temporarily with medications and special diets; liquid vitamin supplements are often given orally to assist lessen deficiencies.

The preferred biliary atresia treatment is that the 
Kasai procedure, a surgical method which will help re-establish bile be due the liver to the intestine by joining the 2 directly. Surgeons begin the procedure, also called a Roux-en-Y, by removing the diseased bile ducts outside the liver. A segment of the tiny intestine is employed to connect the tiny intestine on to the liver at the spot where bile is found or expected to empty . The segment of intestine that connects to the liver also connects to the remainder of the intestine, forming a Y-shaped connection. Surgeons have found that they achieve better results if the Kasai is completed during the infant's first eight weeks of life.

In approximately 80 percent of infants who undergo a biliary atresia Kasai procedure, bile flow is re-established. Between 25 and 30 percent of those infants will have good or complete bile flow after surgery, with normal levels of bilirubin. the opposite 50% will have some bile flow. The remaining 20–25% aren't helped by the Kasai procedure; they gain little or no bile flow. In these cases, the infants would require liver transplantation. Liver transplantation is that the only cure for biliary atresia.



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