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a clinical pearl Diagnosis of biliary atresia
- Thread starter Ahmed Nabil
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A percutaneous cholangiogram is performed by accessing the gallbladder and injecting the dye into gallbladder, demonstrating no communication with the rest of biliary system/duodenum
Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -
"The onset of jaundice may occur at birth or up to 6 weeks thereafter and is typically progressive and eventually accompanied by acholic stools and dark urine."
"The onset of jaundice may occur at birth or up to 6 weeks thereafter and is typically progressive and eventually accompanied by acholic stools and dark urine."
Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -
"Hepatic scintigraphy (HIDA scan) demonstrating relatively good hepatic uptake with the absence of excretion of technetium-labeled compounds from the liver into the duodenum is diagnostic of biliary obstruction, but may be less reliable in cases of severe jaundice. Prior to HIDA scan, patients are routinely pretreated with phenobarbital (5 mg/kg/day) for 5 days to increase biliary secretion by stimulating hepatic enzymes to minimize studies."
"Hepatic scintigraphy (HIDA scan) demonstrating relatively good hepatic uptake with the absence of excretion of technetium-labeled compounds from the liver into the duodenum is diagnostic of biliary obstruction, but may be less reliable in cases of severe jaundice. Prior to HIDA scan, patients are routinely pretreated with phenobarbital (5 mg/kg/day) for 5 days to increase biliary secretion by stimulating hepatic enzymes to minimize studies."
Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -
"biopsy of the liver is the most accurate diagnostic test, but also the most invasive, short of surgical exploration [23, 24]. Pathology characteristically reveals inflammation with ductular proliferation, with or without bile stasis, duct plugging, and giant cells. Indeterminate or false-negative results may reflect specimens acquired too early in the disease process to reflect the characteristic pathologic changes of duct proliferation."
"biopsy of the liver is the most accurate diagnostic test, but also the most invasive, short of surgical exploration [23, 24]. Pathology characteristically reveals inflammation with ductular proliferation, with or without bile stasis, duct plugging, and giant cells. Indeterminate or false-negative results may reflect specimens acquired too early in the disease process to reflect the characteristic pathologic changes of duct proliferation."