Comparison of biliary atresia with and without intracranial hemorrhage
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In brief
In brief
Retrospective study of 63 biliary atresia patients finds 11% developed intracranial hemorrhage, with affected patients showing paradoxically lower hepatobiliary enzymes but severe coagulopathy. ICH patients underwent Kasai procedure at older age and two experienced persistent neurological sequelae, highlighting the critical importance of early coagulation monitoring.
Written by the GCMD Library team from the article.
Background/Purpose
Intracranial hemorrhage (ICH) is a severe complication of biliary atresia (BA). We aimed to compare the clinical data of BA patients with and without ICH.
Methods
Sixty-three BA patients who underwent Kasai portoenterostomy were included in this study. We retrospectively reviewed their clinical records, and compared the ICH and non-ICH groups.
Results
ICH occurred in seven patients (11.1%). The patients with ICH were significantly older at the time of Kasai portoenterostomy (median age: 90.0 vs 65.5 days). The hepatobiliary enzyme levels of the patients with ICH were significantly lower in comparison to the patients without ICH (T-Bil 6.7 vs 9.8 mg/dl; AST 95 vs 194 U/L; ALT 44 vs 114 U/L). On the other hand, the coagulation test values of the patients with ICH were significantly higher in comparison to the patients without ICH (PT 50.0 vs 12.4 s; APTT 200.0 vs 36.9 s). Although the survival rates did not differ to a statistically significant extent, persistent neurological sequelae occurred in two patients in the ICH group.
Conclusions
The hepatobiliary enzyme levels of the patients with ICH were significantly lower than those without ICH. However, coagulopathy was found to be significantly more progressive in patients with ICH.
Levels of Evidence
Level III.