What are the examination items for biliary atresia?

The gallbladder is a relatively small organ in the body, but it is an irreplaceable organ because it is the only organ that can secrete bile, and bile can digest fat and help people take in nutrition. Once the gallbladder becomes diseased, it will directly affect people's digestive system. Among the gallbladder diseases, biliary atresia is the most common and the most harmful. Let's take a look at what items are included in the biliary atresia examination?

Early diagnosis of biliary atresia is still very difficult. The diagnostic methods used are various and vary in means. All of them require comprehensive analysis combined with clinical and laboratory examinations, supplemented by radionuclide examinations, cholangiography and liver puncture biopsy. Early surgical exploration is recommended for those with difficult diagnosis.

Check the diagnosis:

1. Progressive jaundice worsens, stool color changes to clay color, and urine color deepens to red tea color.

2. Abdominal distension, hepatomegaly, and peritoneal effusion.

3. Laboratory tests showed an increase in conjugated bilirubin. Liver function was normal at first, and then transaminase gradually increased.

4. Ultrasound showed biliary atresia.

5. CT shows biliary atresia.

Auxiliary examination:

① Determine the bilirubin in the duodenal drainage fluid: Among those whose duodenal fluid does not contain bilirubin, 90% have congenital biliary atresia, which is helpful for the early diagnosis of congenital biliary atresia.

②131I-RB excretion test and 99mTc-PL scan: Under normal circumstances, after intravenous injection of 131I-RB, it is taken up by liver polygonal cells and excreted into the intestine through bile without being absorbed by the intestine. In children with biliary atresia, Rose Bengal is retained in the liver and does not enter the intestine. Therefore, measuring the 131I content in feces can help understand the condition of bile duct obstruction. Generally, the 131I content in feces is measured 72 hours after intravenous injection of 2UC/kg. In 90% of biliary atresia, the amount of 131I excreted in feces is less than 5%, while in neonatal hepatitis patients, it is almost always above 10%. 99mTc-PL scanning can also help differentiate biliary atresia from neonatal hepatitis.

③ Liver puncture biopsy: Neonatal hepatitis is mainly characterized by hepatocyte lesions, while biliary atresia is mainly characterized by lesions in the bile duct system and portal vein area. Although there are no characteristic changes in the pathological changes of biliary atresia and neonatal hepatitis, only the severity is different, but there are obvious differences in the area of ​​the portal tract, the bile embolus within the lobule per unit area, and the bile embolus between the lobules between the two diseases.

④B-mode ultrasound: In neonatal hepatitis, the intrahepatic and extrahepatic bile ducts, common bile duct, and gallbladder show normal images, but the extrahepatic bile duct of biliary atresia cannot be detected, the gallbladder is deflated or not visible, and the liver is enlarged with splenomegaly.

⑤ Percutaneous transhepatic cholangiography (PTC): This examination can not only be used to identify biliary atresia and neonatal hepatitis, but also children with biliary atresia can undergo PTC examination before surgery to understand the lesions of the intrahepatic and extrahepatic bile ducts and determine the site of obstruction, thereby determining the surgical procedure.