A 3-yr 8-mo-old female was diagnosed as having a congenital stricture of the common hepatic duct. She demonstrated hepatomegaly with marked elevations of serum transaminases, alkaline phosphatase, and bile acids without clinical jaundice or hyperbilirubinemia. Liver biopsy suggested extrahepatic obstruction. Ultrasonography was nondiagnostic, but percutaneous cholangiography demonstrated blockage at the bifurcation of the hepatic ducts. A Roux-en-Y anastomosis of the jejunum to the common hepatic ducts relieved the obstruction and ameliorated clinical evidence of liver disease.
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