Symptoms of Biliary Atresia
Biliary atresia causes yellowish eyes and skin (jaundice) that lasts more than two weeks after birth. Usually the jaundice does not appear until after the first week of life.
It’s also common for healthy babies to have jaundice soon after they’re born. Normally this clears up within the first two weeks. If your baby has jaundice longer, see your baby’s doctor to find out why. Other conditions besides biliary atresia can cause jaundice to linger.
Babies with biliary atresia also have very pale or gray (acholic) stools. Bile gives stools their usual yellow, green or brown color. If bile cannot flow out of the liver into the intestine, your child’s stool will not have these colors. Instead, bile becomes backed up in their liver (cholestasis). This increases the amount of the pigment bilirubin in their blood. It gets passed out in their urine. This can make their urine darker than normal.
If a baby with biliary atresia does not get treatment within the first couple of months after birth, scarring of the liver (cirrhosis) can occur. This scarring cannot be reversed. Cirrhosis can cause other symptoms, like fluid collecting in the belly (ascites) and an enlarged spleen.
Biliary Atresia Diagnosis
If your baby’s doctor suspects biliary atresia, the doctor will start with a thorough exam and will ask about your baby’s health background. Then the doctor will ask for blood tests to tell how your baby’s liver is working and to check bilirubin levels.
Your baby’s doctor may also want to have pictures taken of the inside of your baby’s body, such as an ultrasound and a HIDA scan (hepatobiliary iminodiacetic acid scan). A HIDA scan allows doctors to see whether a special dye that collects in the liver can pass out of the liver through the bile ducts.
To learn more about your baby’s liver and bile ducts, the doctor may order a biopsy. This could mean drawing some cells from your baby’s liver with a syringe (needle biopsy) or doing surgery to remove a small sample of your baby’s liver.
If these tests suggest bile flow is blocked, then surgery is done in most cases. During surgery, doctors can check how well the bile ducts developed and can diagnose atresia. During the same surgery, the surgeon can do the Kasai procedure to improve bile drainage.