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Umbilical hernia and clinical course of patients with bile duct atresia

Sofia Brenes-Guzmán1, Jean Pierre Aurelus1, Susana Aideé González-Chávez2

  • 1Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Pediatría Dr. Silvestre Frenk Freund, Departamento de Cirugía Pediátrica. Ciudad de México, México.

Revista Medica Del Instituto Mexicano Del Seguro Social
|November 7, 2024
PubMed

Insights

Children with biliary atresia (BA) have a higher chance of developing umbilical hernias (UH). This co-occurrence is linked to more severe portal hypertension and related complications in BA patients.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Surgical Pediatrics

Background:

  • Biliary atresia (BA) is the primary cause of pediatric cirrhosis, leading to significant morbidity and mortality.
  • Complications such as gastrointestinal bleeding and portal hypertension are key concerns in BA.
  • Umbilical hernia (UH) has known associations with portal hypertension and cirrhosis, but its specific role in BA progression is unclear.

Purpose of the Study:

  • To determine the prevalence of coexisting biliary atresia and umbilical hernia (BA-UH).
  • To describe the clinical evolution of patients with BA, comparing those with and without UH.
  • To identify prognostic factors for morbidity and mortality in BA patients related to UH presence.

Main Methods:

  • An observational, descriptive, retrospective, and longitudinal study.
  • Inclusion of patients diagnosed with biliary atresia at a tertiary pediatric hospital.
  • Analysis of BA-related variables and clinical outcomes stratified by the presence or absence of UH.

Main Results:

  • The study included 56 patients with BA; 69.6% were female.
  • Umbilical hernia coexisted with BA in 75% of cases.
  • Patients with BA and UH showed significantly higher prevalence of portal hypertension (80.4%), collateral venous networks, gastrointestinal bleeding, ascites, and esophageal varices.

Conclusions:

  • Biliary atresia patients have an increased likelihood of developing umbilical hernias.
  • The presence of an umbilical hernia in BA patients correlates with advanced portal hypertension and its complications.
Abstract

Keywords:
Biliary AtresiaHernia, UmbilicalHypertension, Portal

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