LIVER BILIARY TRACT 10 Atreasia

CONGENITAL BILIARY ATRESIA

Congenital  atresia  of the extrahepatic bile ducts is  the  most

common  cause of prolonged obstructive jaundice in  the  neonatal

period.

INCIDENCE

Biliary atresia occurs once in every 20,000 to 30,000 births.

PATHOLOGY

Failure  of  recanalization  of the ducts which  have  no  lumen.  

Coexistence of atresia of the extrahepatic and entrahepatic ducts

supports  the  belief  that a development anomaly  is  the  basic

defect.

The  procedure  is an attempt to reduce pressure  the  esophageal

veins by :

*   Devasularestion,  the  vessal  supplying  the  upper  greater

    curvature  (spleic bronchea) and the lesser  currature  (left

    gastric branches) are ligated

*   Shunt procedures like a spleno-renal anastamosis or an end to

    side porto-caval an mesenteric vein and canal anastomosis can

    also reduce pressure.

TREATMENT

Surgical  operation to expolore the fibrous tissues at the  Porta

Hepatis  and an anastomosis of bile channels with  an  intestinal

loop provides an outlet for the bile.

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