A Case of Biliary Atresia Associated With Jejunal Atresia

Abstract

We encountered a case of a boy who had been diagnosed with jejunal atresia at two days of age and received jejuno-jejunostomy on the same day. Although his postoperative course was uneventful, he had acholic stools and cholestasis from 17 days of age and was started on cholagogues. The patient was discharged from the hospital at 22 days of age, but his cholestasis persisted. Therefore, he was readmitted to the hospital for further examination, but biliary atresia could not be ruled out. Test laparotomy performed at 59 days of age revealed biliary atresia (III-b1-v), and portoenterostomy (Kasai procedure) was performed. Postoperatively, his cholestasis improved and has been well maintained until the present age of one year. Because cholestasis after surgery for small bowel obstruction often occurs, cholestasis in cases of biliary atresia may be masked, and the timing of an appropriate examination and therapeutic intervention tends to be delayed. In the present study, we reviewed this case and cases of small bowel atresia at our institution. We found that the presence of biliary atresia should be confirmed in patients with cholestasis persisting for more than one month after birth.