eMedicine Specialties > Radiology > Pediatrics

Biliary Atresia: Multimedia

Author: Katherine Zukotynski, MD, Resident Physician, Joint Program in Nuclear Medicine, Harvard Medical School
Coauthor(s): Paul S Babyn, MD, Associate Professor, Department of Medical Imaging, University of Toronto; Radiologist-in-Chief, Department of Diagnostic Imaging, The Hospital for Sick Children
Contributor Information and Disclosures

Updated: Oct 28, 2009

Multimedia

Types of biliary atresia. A, Operable, or correct...
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Media file 1: Types of biliary atresia. A, Operable, or correctable, biliary atresia, a major portion of the extrahepatic bile ducts are patent. B, The inoperable group does not have the patency shown in A. Reproduced with permission from BC Decker, 2000.
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Types of biliary atresia. A, Operable, or correct...

Types of biliary atresia. A, Operable, or correctable, biliary atresia, a major portion of the extrahepatic bile ducts are patent. B, The inoperable group does not have the patency shown in A. Reproduced with permission from BC Decker, 2000.

Classification of biliary atresia according to th...
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Media file 2: Classification of biliary atresia according to the location of involvement (gray areas). Type I is obliteration of the common bile duct while the proximal bile ducts are patent. Type IIa is atresia of the hepatic duct with cystic bile ducts found at the porta hepatis. Type IIb is atresia of the cystic duct, common bile duct, and hepatic ducts. Type III is involvement of the extrahepatic biliary tree and intrahepatic ducts of the porta hepatis.
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Classification of biliary atresia according to th...

Classification of biliary atresia according to the location of involvement (gray areas). Type I is obliteration of the common bile duct while the proximal bile ducts are patent. Type IIa is atresia of the hepatic duct with cystic bile ducts found at the porta hepatis. Type IIb is atresia of the cystic duct, common bile duct, and hepatic ducts. Type III is involvement of the extrahepatic biliary tree and intrahepatic ducts of the porta hepatis.

Histologic findings associated with biliary atres...
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Media file 3: Histologic findings associated with biliary atresia. Image shows end-stage biliary cirrhosis with micronodules (open arrow). Extensive perivascular fibrosis (arrowhead) and dilated inspissated cystic areas (closed arrow) are seen at the hepatic hilum about 5-10 mm from remnants of the obstructed bile duct. Image courtesy of James Phillips, MD, Department of Pathology, Hospital for Sick Children.
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Histologic findings associated with biliary atres...

Histologic findings associated with biliary atresia. Image shows end-stage biliary cirrhosis with micronodules (open arrow). Extensive perivascular fibrosis (arrowhead) and dilated inspissated cystic areas (closed arrow) are seen at the hepatic hilum about 5-10 mm from remnants of the obstructed bile duct. Image courtesy of James Phillips, MD, Department of Pathology, Hospital for Sick Children.

Gallbladder ghost triad in babies with biliary at...
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Media file 4: Gallbladder ghost triad in babies with biliary atresia. Longitudinal scans of the gallbladder in a 3-week-old girl (A) and a 5-week-old boy (B) demonstrate a short gallbladder, an irregular or lobulated contour, and a relatively indistinct lining and wall. Reproduced with permission from Tan Kendrick et al, 2003.
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Gallbladder ghost triad in babies with biliary at...

Gallbladder ghost triad in babies with biliary atresia. Longitudinal scans of the gallbladder in a 3-week-old girl (A) and a 5-week-old boy (B) demonstrate a short gallbladder, an irregular or lobulated contour, and a relatively indistinct lining and wall. Reproduced with permission from Tan Kendrick et al, 2003.

Triangular cord. Transverse (a) and longitudinal...
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Media file 5: Triangular cord. Transverse (a) and longitudinal (b) scans of the triangular cord in a baby with biliary atresia, which appears as a focal echogenic triangular or ovoid density just cranial to the bifurcation of the portal vein. Reproduced with permission from Tan Kendrick AP et al, 2003.
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Triangular cord. Transverse (a) and longitudinal...

Triangular cord. Transverse (a) and longitudinal (b) scans of the triangular cord in a baby with biliary atresia, which appears as a focal echogenic triangular or ovoid density just cranial to the bifurcation of the portal vein. Reproduced with permission from Tan Kendrick AP et al, 2003.

Biliary atresia and central cyst. A, Oblique son...
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Media file 6: Biliary atresia and central cyst. A, Oblique sonogram demonstrates a large cystic structure in the porta hepatis. B, Intraoperative cholangiogram demonstrates filling of the cyst and mildly dilated intrahepatic ducts but no communication with the duodenum. Reproduced with permission from BC Decker, 2000.
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Biliary atresia and central cyst. A, Oblique son...

Biliary atresia and central cyst. A, Oblique sonogram demonstrates a large cystic structure in the porta hepatis. B, Intraoperative cholangiogram demonstrates filling of the cyst and mildly dilated intrahepatic ducts but no communication with the duodenum. Reproduced with permission from BC Decker, 2000.

Anterior technetium-labeled diisopropyl iminodiac...
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Media file 7: Anterior technetium-labeled diisopropyl iminodiacetic acid (IDA) scan in a patient with biliary atresia shows no excretion of the radiopharmaceutical into the bowel at 24 hours.
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Anterior technetium-labeled diisopropyl iminodiac...

Anterior technetium-labeled diisopropyl iminodiacetic acid (IDA) scan in a patient with biliary atresia shows no excretion of the radiopharmaceutical into the bowel at 24 hours.

More on Biliary Atresia

Overview: Biliary Atresia
Imaging: Biliary Atresia
Follow-up: Biliary Atresia
Multimedia: Biliary Atresia
References
Further Reading
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Keywords

biliary atresia, extrahepatic biliary system, extrahepatic bile ducts, intrahepatic bile ducts, fetal biliary atresia, embryonic biliary atresia, postnatal biliary atresia, neonatal obstructive cholestasis, Kasai portoenterostomy procedure, Kasai classification, type I biliary atresia, type II biliary atresia, type III biliary atresia, gallbladder ghost triad, triangular cord sign

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Contributor Information and Disclosures

Author

Katherine Zukotynski, MD, Resident Physician, Joint Program in Nuclear Medicine, Harvard Medical School
Katherine Zukotynski, MD is a member of the following medical societies: Radiological Society of North America
Disclosure: Nothing to disclose.

Coauthor(s)

Paul S Babyn, MD, Associate Professor, Department of Medical Imaging, University of Toronto; Radiologist-in-Chief, Department of Diagnostic Imaging, The Hospital for Sick Children
Paul S Babyn, MD is a member of the following medical societies: Radiological Society of North America
Disclosure: Nothing to disclose.

Medical Editor

Henrique M Lederman, MD, PhD, Consulting Staff, Department of Radiology, LeBonheur Children's Medical Center and St Jude Children's Research Hospital; Professor of Radiology and Pediatric Radiology, Chief, Division of Diagnostic Imaging in Pediatrics, Federal University of Sao Paulo, Brazil
Henrique M Lederman, MD, PhD is a member of the following medical societies: Society for Pediatric Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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