Abstract
A case of biliary atresia (BA) with meconium peritonitis is reported, and its pathogenesis is discussed. The operative findings of meconium peritonitis suggested that bile juice was excreted until the late perinatal phase. After operation, the serum bilirubin was elevated and a second operation was performed for hyperbilirubinemia. An intraoperative cholangiogram revealed type IlIa BA and the main fibrotic remnant connected to the liver which was slightly shifted to the right from the porta hepatis. As the length of the residual small bowel was only 70cm, a hepaticoportocholecystostomy was performed. The structure of this remnant may indicate that the common hepatic duct had had some dysplasia originally. The complete obstruction of the extrahepatic bile duct was thought to have occurred secondary to the influence of meconium peritonitis.
