The Evolution of Biliary Atresia in Early Life

It is well known that biliary atresia (BA) is a progressive process, leading to fibrosis of the bilary tree and the eventual requirement of a hepatoportoenterostomy. The etiology and timing of the onset of this condition remains an enigma. We present the case of an infant admitted to hospital at the age of 11 days with cholestatic jaundice and subsequently diagnosed with biliary atresia. We tracked his fetal ultrasound (US) image which showed a normal gallbladder at the gestational age of 24 weeks. The gallbladder was absent on US when he presented with jaundice. No other liver abnormalities were noted. During the short follow-up, fibrosis around the intrahepatic bile ducts was noted. We therefore conclude that the atretic process started either late in pregnancy or during the perinatal period. We believe that this case report adds to our understanding of the timing of this condition.

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