Diagnosis of biliary atresia in Syrian population

This study aims to define the role of the liver biopsy and scintigraphy in the diagnosis of the bilairy atresia [BA] in a developing country, as the first published study in our country [Syria]. Twenty two patients with cholestatsis, during 2008-2009, were studied for clinical presentations, total bilirubin, SGPT, PT, liver biopsy [LB], scintigraphy [SNT], and cholangiography in positive cases. The false positive and negative cases of SNT were analyzed. Nine patients completed the study, 5 males, and 4 females. Age range between 21 and 120 days, mean age 73.1 days. SNT and LB was incompatible with BA in all 9 cases. Cholangiography proved extrahepatic biliary atresia in 7 cases [77%] and was normal in 2 cases [23%], thus LB and SNT gave false results in these cases. Our study proves again that the diagnosis of biliary atresia can't be made by only one tool, the cholangiogram still the best and final test to make it

Sonographic evaluation of the triangular cord sign in the diagnosis of biliary atresia, confirmed with needle liver biopsy

Neonatal cholestasis continues to present a diagnostic challenge for pediatric surgeons. Various diagnostic protocols are available, often involving invasive procedures which are generally not available in the district general hospitals. The objective of this study is to evaluate the role of Triangular Cord sign [TC sign] on ultrasound for the prompt and easy diagnosis of biliary atresia in infants. A prospective study was planned. Patients with positive TC sign underwent needle liver biopsy for confirmation. Infants with neonatal cholestasis were referred from the gastroenterology department. Abdominal ultrasound was performed with 3-6MHz convex and 6-10MHz linear transducers on Core Vision, Toshiba by a single paediatric radiologist and results were correlated with needle biopsy of the liver interpreted by the histopathologist. Thirty nine Infants with cholestatic jaundice underwent ultrasound and biopsy. Twenty patients were diagnosed on ultrasound as biliary atresia on the basis of positive triangular cord sign and 18 of them were confirmed on biopsy