Biliary Atresia

• Etiology: congenital absence of biliary tree
• US: gallbladder is small to absent, triangular cord sign = bile ductal remnant in porta hepatis, hypertrophied hepatic artery
• HIDA scan: pretreat with phenobarbital 1 week to optimize liver uptake, decreased uptake of radiotracer in liver, no excretion of radiotracer into biliary tree or bowel
• DDX: neonatal hepatitis
• Clinical: associated with polysplenia, preduodenal portal vein, interrupted IVC, transverse liver, cardiac anomalies

Cases of Biliary Atresia