Q: Please tell me you know what biliary atresia means and how it can be affecting our new grandchild. There must be some treatment. I am sure you can understand our concern.
A: About one infant in every 20,000 live births is affected by biliary atresia. This is a very serious disease in which the ducts that carry bile from the liver to the intestines become inflamed and obstructed. The first signs of biliary atresia appear just a few weeks after birth. The baby becomes jaundiced (its skin becomes yellow), its abdomen may swell due to an enlarged, hardened liver. Some infants become extremely itchy.
The cause of this often deadly disease is not yet known, although some researchers believe it may be due to a viral infection around the time of birth. Besides liver transplants, there is only one method of treatment that has been successful in 50 percent of cases.
An operation called the Kasai procedure creates drainage of bile from the liver when the ducts are obstructed. During the surgery, the damaged ducts are replaced with a length of the baby's own intestine, which forms a new duct.
Unfortunately, this procedure only works if the damaged ducts were outside the liver. In many cases, the damaged ducts are inside the liver, and the only hope is a liver transplant. Such transplants are being perfected all the time. The rate of success is also improving because new drugs are being developed that help with the problem of organ rejection. Often, the most difficult problem to overcome is finding a donor organ that is acceptable.
I hope I have managed to answer your many unasked questions and provided you with information, if not the solution you must have wished for.
Dr. Allan Bruckheim welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Bruckheim in care of Tribune Media Services, 435 N. Michigan Avenue, Suite 1400, Chicago, IL 60611.