Example of Type III Biliary Atresia That Changed Various Bile Duct Forms Temporarily

Abstract

We report the case of a girl with biliary atresia that changed the bile duct form that was present during the prenatal period to those after birth and Kasai surgery. She had a cystlike lesion under the liver prenatally, but it disappeared during the course of pregnancy and she showed yellow stools after birth. Abdominal ultrasonography did not show cholangiectasis. Because of her clay-colored feces and icterus two months after birth, she was introduced to our department and Kasai surgery was performed for IIIb1ν-type biliary atresia on the 67th day after birth. Because of the expansion of the intrahepatic bile duct six months after birth, we performed choledochojejunostomy in the liver. Three years after the Kasai surgery, no icterus was observed, and the liver function is currently normal without the expansion of the intrahepatic bile duct. It is necessary to monitor cholangiectasis when it disappears after birth in patients with cholangiectasis prenatally. Even if the intrahepatic bile duct expanded after Kasai surgery, an exploratory operation is important if bile duct anastomosis is possible.