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What is Biliary Atresia?
Biliary atresia is a common liver disease in infants. It is a condition where the baby’s bile ducts get scarred or blocked. Bile ducts are tiny channels that carry secretions from liver cells to the gallbladder and small intestine. When there is a blockage, it prevents the bile from moving out of the liver into the small intestine. The symptoms of this disease manifest one month after birth.
Biliary atresia disease is a common cause of jaundice and can lead to serious liver disease in infants. If not treated appropriately, infants may develop cirrhosis and die of complications.
Synopsis
Symptoms of Biliary Atresia
Early signs of Biliary Atresia are seen when the baby is a few weeks old. These include:
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Pale/light colour/clay stools
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Yellowish eyes – an indication of Jaundice
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Dark or amber-coloured urine (staining the clothes & diapers)
The symptoms noticed when the infant is 6 to 10 weeks old include:
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Itchy skin
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Irritability
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Underweight
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Swollen belly
Consult our paediatric and childcare hospital in Old Airport Road if you are experiencing biliary atresia symptoms
How is Biliary Atresia Diagnosed?
The diagnosis includes a liver function test and a bilirubin test, apart from an ultrasound scan of the liver. Sometimes, a hepatobiliary iminodiacetic acid (HIDA) scan and liver biopsy (a tiny piece of liver examined under a microscope) can help us diagnose this condition.
There are three components of the bilirubin test:
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Total Bilirubin
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Conjugated Bilirubin
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Unconjugated Bilirubin
Many healthcare facilities consider only the conjugated bilirubin. However, checking all components is crucial for an accurate diagnosis of any underlying liver-related condition. There are two types of jaundice: normal and abnormal/pathological jaundice. Biliary atresia causes an abnormal type of jaundice. Here, the conjugated bilirubin levels are high.
What Are Abnormal Bilirubin Levels?
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If the total bilirubin is > 5 mg and the conjugated fraction is > 20%
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If the total bilirubin is < 5 mg and the conjugated fraction is > 1 mg
The above levels should be evaluated when the 1st well-child visit (the first vaccination visit for the child) is done in the 6th week.
Treatment for Biliary Atresia
When a child with biliary atresia is diagnosed early, a surgical procedure called Kasai Portoenterostomy is recommended as the most preferred treatment option. In this surgery, doctors bypass the damaged bile ducts using an intestinal channel to create a new path. This helps re-establish bile flow from the liver to the small intestine.
If biliary atresia diagnosis is delayed or treatment is not initiated beyond 90 days after birth or the liver damage is already established, the only option left is liver transplantation (LT). In fact, this is the most common indication of liver transplantation in children, accounting for 50% of all cases of LT.
Children who receive liver transplantation have an excellent outcome; they survive, grow, and thrive as normal adults.
Visit our skilled Paediatric Gastroenterologists at Manipal Hospital Old Airport Road, Bangalore and ensure your baby receives appropriate biliary atresia treatment and a healthy start to life.
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