Biliary Atresia and Inguinal Hernia

The recent publication on biliary atresia (BA) and inguinal hernia in cases receiving Kasai portoenterostomy is very interesting.[1] In this letter, Zani and Davenport suggested that “BA infants have a high incidence of inguinal hernias, which seems related to degree of liver fibrosis at presentation and presumably degree of ascites and increased intra-abdominal pressure.[1]” This conclusion is quite interesting. Whether the high incidence in this letter is an actual clinically significant observation or accidental finding should be further investigated. The authors would like to share observation from a corresponding's author recent report[2] on a larger group of BA (sample size approximately two times the present study). Of interest, although similar findings on severe liver pathology and clinical presentation could be seen, there is no case with inguinal hernia.[2] Zani and Davenport's first report has to be supported by other case series before conclusion for the relationship between BA and inguinal hernia.

• References

• 1 Zani A, Davenport M. Inguinal hernias associated with biliary atresia. Eur J Pediatr Surg 2012; 22 (2) 117-120
• 2 Joob B. Kasai operation: a summary on Thai experience. Diag Ther Stud 2012; 1 (2) 52-53