Outcomes of biliary atresia in the Nordic countries - a multicenter study of 158 patients during 2005-2016.

Background/purpose: Biliary atresia is the most common reason for newborn cholestasis and pediatric liver transplantation. Even after normalization of serum bilirubin after portoenterostomy, most patients require liver transplantation by adulthood due to expanding fibrosis. We addressed contemporary outcomes of biliary atresia in the Nordic countries.

Hepatobiliary scintigraphy for early diagnosis of biliary atresia.

Introduction: The aim of this study was to evaluate the validity of (99m)Technetium-trimethylbromo-iminodiacetic acid hepatobiliary scintigraphy (HS) for the diagnosis of biliary atresia (BA).

Methods: From January 2005 to December 2009, a total of 47 infants with conjugated hyperbilirubinaemia (> 20 micromol/l total bilirubin of which 20% is conjugated) underwent HS. BA was suspected if no tracer was visualised in the gut 24 hours post-injection.

Prophylactic Dosing of Vitamin K to Prevent Bleeding.

Background And Objectives: Based on a high incidence of Vitamin K deficiency bleeding (VKDB) in breastfed infants with thus far unrecognized cholestasis, such as biliary atresia (BA), the Dutch regimen to prevent VKDB in breastfed infants was changed from a daily oral dosage of 25 µg to 150 µg vitamin K. Infants continued to receive 1 mg of vitamin K orally at birth. We compared the efficacy of the 150-µg regimen with the 25-µg regimen and with the Danish regimen of a single intramuscular (IM) dose of 2 mg vitamin K at birth.

Increased conjugated bilirubin is sufficient to initiate screening for biliary atresia.

Introduction: Biliary atresia is the leading cause of liver transplantation in children. It affects 1:15,000 in Denmark. With a national birth rate of 60,000, four children are born every year with biliary atresia.

[The plasma anion gap is a useful tool for evaluating children with metabolic acidosis].

Metabolic acidosis occurs frequently in hospitalized children. The causes are many and often apparent from the history and physical examination. However, if the aetiology is unclear, the plasma anion gap is a useful tool for evaluating patients with metabolic acidosis.