الفهرس 
Review of literatureOnly 14 pages are availabe for public view
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Abstract
Biliary atresia (BA) is an infantile disorder characterized by the complete obstruction of a portion or the entire length of the extrahepatic or intrahepatic bile ducts caused by a fibro-inflammatory process that disrupts the flow of bile from the liver to the duodenum.
Untreated BA leads to cirrhosis and death within the first years of life. Surgical treatment usually involves an initial attempt to restore bile flow thorough the Kasai portoenterostomy which is performed as soon after diagnosis as possible. Later, liver transplantation may be needed if the Kasai operation fails to restore the biliary flow or if cirrhosis complications occur. BA remains the most common indication for pediatric liver transplantation worldwide.
Missing BA caries a grave prognosis as it means lost opportunity for effective treatment that results in liver failure occurring within 2 years without liver transplantation. Furthermore, subjecting a large proportion of patients of NC cases for laparotomy without sure diagnosis as a sizeable proportion of cases may not have BA, thus contributing to morbidity and high cost of treatment without any benefit. Early diagnosis in such cases is critical as timing of surgery correlates with the outcome.
Ultrasonography (US) serves as a screening tool used in determining the cause of jaundice. The presence of the triangular cord(TC) sign, an abnormal gallbladder (GB) and hyperplasic and hypertrophic changes in branches of the hepatic artery are important imaging features observed in patients with BA during US examination.
The presence of angiographically demonstrable perivascular arterial tufts in the periphery of the hepatic arterial circulation might be useful in the diagnosis of BA patients. However, angiographic evaluation is not routinely performed for the diagnosis of BA.
Thus color Doppler US may reflect hypertrophy and hyperplasia of the hepatic artery as well as hepatic subcapsuar flow which represent the perivascular arterial tufts in the periphery of the hepatic arterial circulation that surrounds the peripheral occluded small arterial branches in patients with BA. The pathogenesis of hepatic arteriopathy in BA involves fibrosis, however, it is suggested that ductal plate malformation is often associated with abnormalities in the ramification of the portal vein and in the hyperplasia and hypertrophy of the hepatic artery branches in the portal tract.