| Peer-Reviewed

Clinical Manifestation of Biliary Atresia in Bali

Received: 16 October 2021    Accepted: 3 November 2021    Published: 10 November 2021
Views:       Downloads:
Abstract

Biliary atresia is a rare disease of the liver and bile ducts that occurs in infants. Biliary atresia is a condition in which the absence of a lumen in the extrahepatic biliary tract causes obstruction of bile flow. Symptoms of the disease appear or develop about two to eight weeks after birth. This study aims to describe the clinical manifestations of patients with Biliary Atresia at Sanglah General Hospital, Bali. This cross-sectional study was performed at the Sanglah Hospital Denpasar, Bali. Data was taken from medical record from January 2015 - December 2020. Study population were children who diagnosed as Biliary Atresia. Diagnosis was confirmed by cholangiography and liver biopsy. The study included 30 infants with Biliary Atresia, mostly (70%) were girl. Average age at admission was 3 months. Ninety percent subject had hepatomegaly in physical examination. Acholic stool were found in 80% subject. The average serum levels of conjugated bilirubin were 9.8 mg/dL, alanine aminotransferase (ALT) was 182 u/L, aspartate transaminase (AST) was 324 u/L, gamma-glutamyl transpeptidase (GGT) level was 671 u/L and albumin was 3.8 g/dL. Seventy percent patient showed triangular cord sign in abdominal ultrasonography. Kasai procedure was performed to all those infants. The most common clinical manifestation was icteric, dark urine, acholic stool and hepatomegaly. Triangular cord sign was the most common finding in abdomen ultrasonography.

Published in American Journal of Pediatrics (Volume 7, Issue 4)
DOI 10.11648/j.ajp.20210704.14
Page(s) 203-206
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Biliary Atresia, Profile, Clinical Manifestation

References
[1] Alagille D. Extrahepatic biliary atresia. Hepatology. 1984; 4: 7S-10S.
[2] Houwen RH, Kerremans I, van Steensel-Moll HA, van Romunde LK, Bijleveld CM, Schweizer P. Time-space distribution of extrahepatic biliary atresia in The Netherlands and West Germany. Z Kinderchir. 1988; 43: 68-71.
[3] Mouzaki M, Bronsky J, Gupte G, et al: Nutrition support of children with chronic liver diseases: A joint position paper of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 69 (4): 498-511, 2019.
[4] Sokol RJ, Narkewicz MR. Liver & pancreas. In: Hay WR, Levin Mj, Sondheimer JM, Deterding RR, eds. Current Diagnosis & Treatment in Pediatrics. 18th ed. New York: McGraw-Hill 2007. p. 638-48.
[5] Chardot C, Carton M, Spire-Bendelac N, Le Pommelet C, Golmard JL, Auvert B. Prognosis of biliary atresia in the era of liver transplantation: French national study from 1986 to 1996. Hepatology. 1999; 30: 606–611.
[6] Cambell KM, Bezzere JA. Biliary atresia. Dalam: Walker WA, Goulet Olivier et al, penyunting. Pediatric gastrointestinal disease. Edisi keempat. Ortario: BC Decker Company; 2004. h. 122-35. Eggimann P, Pittet D. Infection control in the ICU: critical care reviews. Chest 2001; 120 (6): 2059-93.
[7] Wada H, Muraji T, Yokoi A, et al. Insignificant seasonal and geographical variation in incidence of biliary atresia in Japan: a regional survey of over 20 years. J Pediatr Surg 2007; 42: 2090.
[8] Yoon PW, Bresee JS, Olney RS, James LM, Khoury MJ: Epidemiology biliary atresia: a population-based study. Pediatrics 1997, 99: 376-382.
[9] Dehghani SM, Haghighat M, Imanieh MH, Geramizadeh B. Comparison of different diagnostic methods in infants with Cholestasis. World J Gastroenterol. 2006; 12: 5893-6.
[10] Witt M, Lindeboom J, Wijnja C, Kesler A, Keyzer-Dekker CM, Verkade HJ, et al. Early detection of neonatal cholestasis: Inadequate assessment of stool color by parents and primary healthcare doctors. Eur J Pediatr Surg. 2016; 26: 67-73.
[11] Gupta DK, Rohatgi M, Bajpai M. Biliary Atresia. J Indian Assoc Pediatr. Surg. 2008 Apr-Jun; 13 (2): 49-56.
[12] Rendon-Macias ME, Villasis-Keever MA, Castaneda-Mucino G. Improvement in accuracy of gamma-glutamyl transferase for diff erential diagnosis of biliary atresia by correlation with age. Turk J Pediatr 2008; 50: 253-59.
[13] Carvalho E, Ivantes CAP, Bezerra JA. Extrahepatic biliary atresia: current concepts and future directions. J Pediatr (Rio J). 2007; 83 (2): 105-120.
[14] Situmorang L, Setyoboedi, Mastutik G. Infection of Cytomegalovirus in Cholestasis Infant with Biliary Atresia. Clinical Pathology and Medical Laboratory 2020 March; 26 (2): 175-181.
[15] Zhou L, Shan Q, Tian W, Wang Z. Ultrasound for the Diagnosis of Biliary Atresia: A Meta-Analysis. American Journal of Roentgenology. 2016; 206.
[16] Lee MS, Kim MJ, Lee MJ. Color Doppler US Findings in Neonates and Infants. Radiology 2009; 252-1.
[17] Davenport M, de Ville de Goyet J, Stringer M D. et al Seamless management of biliary atresia in England and Wales (1999–2002). Lancet 20043631354-1357.
[18] Davenport M, Puricelli V, Farrant P, Hadzic N, Mieli-Vergani G, Portmann B, et al. The outcome of the older (>100 days) infant with biliary atresia. J Pediatr Surg. 2004; 39: 575-81.
Cite This Article
  • APA Style

    Merry Natalia, I Gusti Ngurah Sanjaya Putra, Ni Nyoman Metriani Nesa, I Putu Gede Karyana. (2021). Clinical Manifestation of Biliary Atresia in Bali. American Journal of Pediatrics, 7(4), 203-206. https://doi.org/10.11648/j.ajp.20210704.14

    Copy | Download

    ACS Style

    Merry Natalia; I Gusti Ngurah Sanjaya Putra; Ni Nyoman Metriani Nesa; I Putu Gede Karyana. Clinical Manifestation of Biliary Atresia in Bali. Am. J. Pediatr. 2021, 7(4), 203-206. doi: 10.11648/j.ajp.20210704.14

    Copy | Download

    AMA Style

    Merry Natalia, I Gusti Ngurah Sanjaya Putra, Ni Nyoman Metriani Nesa, I Putu Gede Karyana. Clinical Manifestation of Biliary Atresia in Bali. Am J Pediatr. 2021;7(4):203-206. doi: 10.11648/j.ajp.20210704.14

    Copy | Download

  • @article{10.11648/j.ajp.20210704.14,
      author = {Merry Natalia and I Gusti Ngurah Sanjaya Putra and Ni Nyoman Metriani Nesa and I Putu Gede Karyana},
      title = {Clinical Manifestation of Biliary Atresia in Bali},
      journal = {American Journal of Pediatrics},
      volume = {7},
      number = {4},
      pages = {203-206},
      doi = {10.11648/j.ajp.20210704.14},
      url = {https://doi.org/10.11648/j.ajp.20210704.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20210704.14},
      abstract = {Biliary atresia is a rare disease of the liver and bile ducts that occurs in infants. Biliary atresia is a condition in which the absence of a lumen in the extrahepatic biliary tract causes obstruction of bile flow. Symptoms of the disease appear or develop about two to eight weeks after birth. This study aims to describe the clinical manifestations of patients with Biliary Atresia at Sanglah General Hospital, Bali. This cross-sectional study was performed at the Sanglah Hospital Denpasar, Bali. Data was taken from medical record from January 2015 - December 2020. Study population were children who diagnosed as Biliary Atresia. Diagnosis was confirmed by cholangiography and liver biopsy. The study included 30 infants with Biliary Atresia, mostly (70%) were girl. Average age at admission was 3 months. Ninety percent subject had hepatomegaly in physical examination. Acholic stool were found in 80% subject. The average serum levels of conjugated bilirubin were 9.8 mg/dL, alanine aminotransferase (ALT) was 182 u/L, aspartate transaminase (AST) was 324 u/L, gamma-glutamyl transpeptidase (GGT) level was 671 u/L and albumin was 3.8 g/dL. Seventy percent patient showed triangular cord sign in abdominal ultrasonography. Kasai procedure was performed to all those infants. The most common clinical manifestation was icteric, dark urine, acholic stool and hepatomegaly. Triangular cord sign was the most common finding in abdomen ultrasonography.},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Clinical Manifestation of Biliary Atresia in Bali
    AU  - Merry Natalia
    AU  - I Gusti Ngurah Sanjaya Putra
    AU  - Ni Nyoman Metriani Nesa
    AU  - I Putu Gede Karyana
    Y1  - 2021/11/10
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajp.20210704.14
    DO  - 10.11648/j.ajp.20210704.14
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 203
    EP  - 206
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20210704.14
    AB  - Biliary atresia is a rare disease of the liver and bile ducts that occurs in infants. Biliary atresia is a condition in which the absence of a lumen in the extrahepatic biliary tract causes obstruction of bile flow. Symptoms of the disease appear or develop about two to eight weeks after birth. This study aims to describe the clinical manifestations of patients with Biliary Atresia at Sanglah General Hospital, Bali. This cross-sectional study was performed at the Sanglah Hospital Denpasar, Bali. Data was taken from medical record from January 2015 - December 2020. Study population were children who diagnosed as Biliary Atresia. Diagnosis was confirmed by cholangiography and liver biopsy. The study included 30 infants with Biliary Atresia, mostly (70%) were girl. Average age at admission was 3 months. Ninety percent subject had hepatomegaly in physical examination. Acholic stool were found in 80% subject. The average serum levels of conjugated bilirubin were 9.8 mg/dL, alanine aminotransferase (ALT) was 182 u/L, aspartate transaminase (AST) was 324 u/L, gamma-glutamyl transpeptidase (GGT) level was 671 u/L and albumin was 3.8 g/dL. Seventy percent patient showed triangular cord sign in abdominal ultrasonography. Kasai procedure was performed to all those infants. The most common clinical manifestation was icteric, dark urine, acholic stool and hepatomegaly. Triangular cord sign was the most common finding in abdomen ultrasonography.
    VL  - 7
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Department of Child Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia

  • Sections