Biliary Atresia: Tests and Diagnosis

How is biliary atresia diagnosed?

It is important to make the diagnosis of biliary atresia early. This is because the long-term outcome depends on the age of initial surgical intervention (known as the Kasai procedure). Therefore, any newborn older than 2 weeks with jaundice should have blood tests to see if there is a liver problem. If so, other tests are likely to be done.

At Children's Hospital Colorado, the other tests performed include:

  • Abdominal ultrasound: a painless way to look at the liver, gallbladder and surrounding organs using sound waves.
  • Liver biopsy: the child is given an anesthetic and a tiny cut is made over the lower part of the ribs on the right side. A small needle is then passed through that cut. A tiny piece of tissue is taken from the liver to look at under the microscope.
  • Explorative laparotomy: the diagnosis of biliary atresia is confirmed at surgery. The surgeon can directly inspect the biliary tree (drainage system) and inject dye to see if there is a blockage. The surgeon may also take a sample of tissue from the liver.