Cases reported "Biliary Atresia"

Filter by keywords:



Filtering documents. Please wait...

1/43. liver transplantation in patients with situs inversus.

    Two patients with situs inversus and biliary atresia were treated with hepatic transplantation, one with an auxiliary liver and the other with an orthotopic graft which was placed using a piggy-back technique. Both transplants functioned well initially. The auxiliary liver was rejected after 1 1/2 months, and the patient died after an attempt at retransplantation many months later. The recipient of the orthotopic liver has perfect liver function 10 months postoperatively.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

2/43. Antenatal diagnosis of biliary atresia (noncorrectable cyst type): a case report.

    At 32 weeks of gestation a cystic mass was identified in the hepatic hilum of a fetus by maternal sonography. laparotomy was performed at 39 days of life after a diagnosis of correctable type of biliary atresia (Type I). A cystically dilated extrahepatic duct, in which the proximal and distal sides of the common bile duct were occluded (Type III with cyst, noncorrectable type), was identified by operative cholangiography. A standard Kasai operation was performed, and 1 year after operation the patient was doing well and was jaundice-free. From this experience in routine maternal sonography, a cystic mass in the hepatic hilum may also suggest Type III biliary atresia with a cyst.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

3/43. Pulmonary hypertension associated with postoperative biliary atresia: report of two cases.

    The authors report on 2 patients with biliary atresia in whom pulmonary hypertension (PH) developed in the long-term follow-up after hepatoportoenterostomy. Both had portal hypertension and had undergone distal splenorenal shunt. dyspnea developed around 14 to 15 years of age. cardiac catheterization showed pulmonary artery pressure (PAP) of 99/37 (58) and 67/32 (48) mm Hg, respectively, which did not respond to vasodilators. One patient suffered from respiratory tract infection followed by right heart failure and subsequent death at 20 years of age. Postmortum histological findings exhibited severe thickening of the pulmonary artery wall. PH may grow insidiously even after successful hepatoportoenterostomy. Careful monitoring of PAP and hemodynamic response of PAP to vasodilators is essential for evaluating the reversibility of PH and making treatment decisions.
- - - - - - - - - -
ranking = 4
keywords = operative
(Clic here for more details about this article)

4/43. Transjugular intrahepatic portosystemic shunt performed in a 2-year-old infant with uncontrollable intestinal bleeding.

    Although transjugular intrahepatic portosystemic shunt (TIPS) is widely accepted in adults, there have been few successful reports in infants. The authors describe a 2-year-old boy with postoperative biliary atresia who underwent TIPS for uncontrollable lower intestinal bleeding and achieved hemostasis. Massive melena developed, which was not controlled by conservative therapy and devascularization. A shunt was created between the right hepatic vein and the right portal vein with a 6- x 50-mm Wallstent. After TIPS, the porto-systemic pressure gradient decreased from 15 to 11 mm Hg, and collaterals markedly reduced. He has not had recurrent bleeding for over 7 months. TIPS may be a technically feasible and effective treatment to control intestinal bleeding in infants. However, further experience and long-term follow-up will be required.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

5/43. A case of biliary atresia with cystic dilatation of the extrahepatic bile duct and polysplenia syndrome.

    A 79-day-old girl presented with jaundice and acholia. Laboratory findings disclosed elevated levels of bilirubin, transaminases, and gamma-glutamyl transferase. A chest x-ray film showed dextrocardia. A computed tomographic scan revealed a cystic mass at the porta hepatis, multiple spleens in the right side of the abdomen, and absence of the inferior vena cava. Under the diagnosis of biliary atresia (BA) (I-cyst) associated with polysplenia syndrome, a hepatic portojejunostomy was performed at 80 days of age. The postoperative course was uneventful, and the jaundice cleared. Although the occurrence of associated anomalies in BA is rare, polysplenia is most commonly seen, and its incidence is reported to be 2% to 10%. patients with BA and polysplenia usually have a poor prognosis, however, this patient may have a good prognosis due to uneventful recovery from the jaundice.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

6/43. Effective percutaneous transhepatic biliary drainage for cystic dilatation of the intrahepatic biliary system in biliary atresia: a case report.

    We report on a 16-year old girl with postoperative biliary atresia developing cystic dilatation of the intrahepatic biliary system (CDIB) with abdominal pain, which was relieved after percutaneous transhepatic biliary drainage (PTBD). A cyst was detected in segment 4 of the liver at the age of 14 years. She developed severe right hypochondralgia, subfever and liver dysfunction. Percutaneous cholangiogram showed a solitary cyst without communication and a PTBD tube was placed within the cyst. After lavage of the cyst through PTBD, CDIB was re-communicated with the intestine and the pain was relieved with reduction of the cyst size. From this experience, PTBD may be a less invasive treatment as the first choice for non-communicating CDIB and may alleviate the symptoms when recommunication with the intestine is obtained.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

7/43. liver transplantation for biliary atresia associated with malignant hepatic tumors.

    The authors report 3 cases of liver transplantations in children between 4 and 10 years of age, complicated with malignant hepatic tumors after biliary atresia. The preoperative abdominal computed tomography (CT) scans of all 3 cases showed hepatic masses. The serum alpha-fetoprotein levels were elevated highly in 2 cases. After living-related liver transplantation (LRLT), the pathologic findings of the masses in the resected livers showed hepatocellular carcinoma in 2 cases and hepatoblastoma in the other. All cases were associated with biliary cirrhosis. The stage of the liver tumor in the 3 cases using the TNM system was IVA (T4, N0, M0), II (T2, N0, M0) and IVA (T4, N0, M0). Chemotherapy was used in all cases after liver transplantation, and all patients survived with no recurrence. The results suggest that even though malignant liver tumors rarely are complicated with biliary atresia in childhood, one should be alert to the occurrence of hepatic malignancy and perform routine screening of alpha-fetoprotein levels, abdominal CT scans, and magnetic resonance imagings.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

8/43. A case of biliary atresia with duplication of the common bile duct.

    The authors report a case of biliary atresia (BA) with duplication of the common bile duct. A 1-month-old girl was referred for investigation of persistent jaundice. BA was suspected and confirmed with intraoperative cholangiography. A portoenterostomy was performed at 50 days of age. During dissection of the fibrous remnant of the common bile duct, a separate fibrous bile duct remnant running in parallel on the left, was identified. Histologically, there was bile duct proliferation at the porta hepatis of the left bile duct remnant. A diagnosis of BA with duplicated common bile duct was made. Postoperative course was uneventful, and at a follow-up assessment at 7 months, she was jaundice free, and her progress has been unremarkable.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)

9/43. liver transplantation from situs inversus to situs inversus.

    Congenital anatomic anomalies often present technical obstacles during liver transplantation. biliary atresia (BA) is the most common indication for liver transplantation in children, and up to 28% of children with situs inversus are complicated by BA. A boy aged 2 years 11 months with BA, situs inversus, and dextrocardia received a liver transplant from his father. The donor also had situs inversus and dextrocardia without other anomalies. Graft function was excellent postoperatively, and no significant complications were encountered. This is only the second report of the successful use of a living related donor graft for a patient with BA and situs inversus. This case was particularly rare because the donor also had situs inversus, which made the present procedure more feasible.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

10/43. Laparoscopic Kasai portoenterostomy for biliary atresia.

    Conventional surgery for extrahepatic bile-duct atresia (EHBDA) usually requires a large, painful, muscle-cutting laparotomy, dislodgment of the liver, and wide manipulations, followed by adhesions and possible complications that may disturb the postoperative course and hamper liver transplantation (LT). The main role of laparoscopy in EHBDA has been for diagnostic purposes. Besides all the advantages of minimally-invasive access, it allows excellent visibility and dissection of tiny hilar structures. The authors present the first two cases of successful Roux-en-Y laparoscopic portoenterostomy (LARP) for EHBDA, showing the importance of advanced technical skills and a new approach for extracorporeal enteroanastomosis. Laparoscopic hilar dissection and portoenterostomy was accomplished using four trocars. The umbilical site was used for extracorporeal Roux-en-Y enteroenterostomy, in the first case using a laparoscopic stapler and in the second a hand-sewn suture. Mean operative time was 190 min, and no operative complications were observed. Both girls became anicteric. The first is doing well 15 months after the operation with good hepatic function. The other was anicteric for 6 months, had one episode of cholangitis, developed an umbilical hernia, has shown slow and progressive hepatic failure, and is now being evaluated for possible LT. It is concluded that LARP for EHBDA can be done safely in infants using an extracorporeal transumbilical enteric anastomosis, with several advantages compared with open surgery. The role of LARP in facilitating LT is yet to be defined.
- - - - - - - - - -
ranking = 3
keywords = operative
(Clic here for more details about this article)
| Next ->


Leave a message about 'Biliary Atresia'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.