2017 Volume 53 Issue 4 Pages 958-961
We herein report a case of biliary atresia (BA) in a preterm female infant delivered by caesarean section on the 33rd week of gestation. Her birth weight was 1,425 g. Her stool color changed from green to gray after the 7th day of age. Therefore, both abdominal ultrasonography and biliary scintigraphy were performed, and on the basis of the results of which, BA was suspected. We carefully observed her stool color and serum bilirubin level and monitored her weight gain. On the 37th day of age (corrected age: 38 weeks, 5 days of gestation), laparotomy for accurate diagnosis was performed. Intraoperative cholangiography showed BA (I-b1-β), and then Kasai’s portoenterostomy was carried out. On the 45th day after the procedure, she was discharged and her postoperative clinical course continued to be uneventful for 5 months after the discharge. In Japan, BA infants with very or extremely low birth weight are very rare, estimated to be less than 1% of BA infants. Unfortunately, there are only a few studies clarifying the operation timing and postoperative prognosis in such BA cases. Therefore, on the basis of our experience and the literature, we discussed Kasai’s operation timing for biliary atresia in preterm infants or very low birth weight infants.