Early Kasai portoenterostomy in a 9-day-old newborn with extrahepatic biliary atresia: a case report highlighting improved prognosis with prompt intervention

Extrahepatic biliary atresia (EHBA) is a leading cause of neonatal cholestasis, often resulting in end-stage cirrhosis and portal hypertension without early diagnosis and treatment. This report highlights the importance of timely intervention, describing a 6-day-old male newborn diagnosed with EHBA...

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Bibliographic Details
Published in:Journal of international medical research 2025-02, Vol.53 (2), p.3000605241311115
Main Authors: El-Shabrawi, Mortada H F, Eltagy, Gamal, Qinawy, Mohamed, Oshi, Mohammed Am, Algethami, Amjad, Alhujayri, Nawaf A, Alharthi, Shaker S, Alelyani, Abdullah M, Kamal, Naglaa M
Format: Article
Language:English
Subjects:
Biliary Atresia - diagnosis
Biliary Atresia - surgery
Case Report and Case Series
Humans
Infant, Newborn
Liver Function Tests
Male
Portoenterostomy, Hepatic - methods
Prognosis
Treatment Outcome
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Summary:Extrahepatic biliary atresia (EHBA) is a leading cause of neonatal cholestasis, often resulting in end-stage cirrhosis and portal hypertension without early diagnosis and treatment. This report highlights the importance of timely intervention, describing a 6-day-old male newborn diagnosed with EHBA who underwent successful Kasai portoenterostomy at 9 days of age. While the procedure is typically performed within the first 60 days of life, this exceptionally early intervention led to significantly improved outcomes. Postoperative recovery was marked by bilirubin normalization within 2 months and steady improvement in liver function tests, demonstrating the advantages of early surgery. The procedure involved creating a Roux-en-Y hepatic portojejunostomy to restore bile flow, preventing progression to biliary cirrhosis. Early intervention achieved effective bile drainage and substantial clinical improvement. At the 1-year follow-up, the infant displayed normal growth and liver function. This case supports the hypothesis that performing Kasai portoenterostomy earlier than current guidelines recommend may lead to better outcomes. It underscores the need for vigilant neonatal care to recognize early signs of cholestasis and enable prompt surgical intervention. Early diagnosis and intervention can preserve liver function, potentially delaying or preventing the need for liver transplantation.
ISSN:0300-0605
1473-2300
1473-2300
DOI:10.1177/03000605241311115