Biliary Atresia

Abstract

Objectives: To determine the accuracy of ultrasound in diagnosing biliary atresiataking histopathology as gold standard. Design: Cross Sectional Study. Settings: Departmentof Diagnostic Radiology and Gastroenterology at Children’s Hospital and Institute of ChildHealth, Lahore. Period: Over 1 year from 13-01-2015 to 12-02-2016. Material and Methods:This study involved 210 infants aged between 2-6 weeks referred from outpatient departmentand emergency of gastroenterology department with suspicion of biliary atresia. Ultrasoundof all these cases was carried out and biliary atresia was labeled on a positive triangular cordsign. Core needle biopsy sample was taken from the liver adjacent to the porta hepatis andhistopathological examination was done. Results of histopathology were taken as gold standardand results of ultrasonography were judged accordingly as true positive or false positive. Awritten informed consent was taken from each patient. A predesigned proforma was used torecord patient’s demographic details along with ultrasound and histopathological diagnosis.Results: The mean age of the patients was 4.31±1.22 weeks. There were 109 (51.9%) maleand 101 (48.1%) female patients with a male to female ratio of 1.1:1. Ultrasound was found97.5% sensitive, 87.7% specific and 95.2% accurate with positive and negative predictive valueof 96.31% and 91.5%, respectively. Conclusion: Ultrasound was found extremely sensitive toolfor the diagnosis of biliary atresia. Its non-invasive nature and lack of radiation exposure furthermake it ideal for pre-operative diagnosis in suspected cases in future practice.