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Comparison of biliary atresia with and without intracranial hemorrhage

Yoshiaki Takahashi1, Toshiharu Matsuura1, Koichiro Yoshimaru1

  • 1Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.

Journal of Pediatric Surgery
|May 26, 2018
PubMed

Insights

Intracranial hemorrhage (ICH) in biliary atresia (BA) patients is linked to later Kasai portoenterostomy and poorer liver enzyme levels. Coagulopathy is more severe in BA patients with ICH.

Area of Science:

  • Pediatric Surgery
  • Hepatology
  • Neurology

Background:

  • Intracranial hemorrhage (ICH) is a serious complication in biliary atresia (BA).
  • Understanding clinical differences in BA patients with and without ICH is crucial for management.

Purpose of the Study:

  • To compare clinical data between BA patients who developed ICH and those who did not.
  • To identify potential risk factors and clinical characteristics associated with ICH in BA.

Main Methods:

  • Retrospective review of clinical records for 63 BA patients who underwent Kasai portoenterostomy.
  • Comparison of clinical parameters, including age at surgery, liver enzyme levels, and coagulation tests, between ICH and non-ICH groups.

Main Results:

  • ICH occurred in 11.1% of BA patients.
  • ICH patients were older at Kasai portoenterostomy (90.0 vs 65.5 days) and had lower T-Bil, AST, and ALT levels.
  • ICH patients exhibited significantly prolonged PT (50.0 vs 12.4 s) and APTT (200.0 vs 36.9 s), indicating more severe coagulopathy.

Conclusions:

  • Lower hepatobiliary enzyme levels and more progressive coagulopathy are associated with ICH in BA patients.
  • While survival rates were similar, neurological sequelae were observed in two ICH patients.
Abstract

Keywords:
Biliary atresiaCoagulopathyIntracranial hemorrhageVitamin K-deficiency bleeding

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