PMC5727568_01
Abdominal ultrasound demonstrating a present gallbladder.
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An abdominal ultrasound had no evidence of choledochal cyst and demonstrated the presence of a gallbladder but was equivocal for presence of the common bile duct (Figure 1).
HIDA scan without excretion into the intestine.
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A hepatobiliary iminodiacetic acid (HIDA) scan was performed to assess for biliary patency, and this failed to demonstrate excretion of the radioactive tracer into the duodenum (Figure 2).
Intraoperative biopsy demonstrating bile duct proliferation.
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Histopathology demonstrated bile duct proliferation (Figure 3), cholestasis (Figure 4), chronic inflammation, and periportal fibrosis without bridging, consistent with the diagnosis of BA; additionally, hepatocytes with PAS-positive, diastase-resistant globules (Figure 5) were seen supporting the additional diagnosis of A1AT.
Intraoperative biopsy showing cholestasis and bile duct plugging.
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fig4
Histopathology demonstrated bile duct proliferation (Figure 3), cholestasis (Figure 4), chronic inflammation, and periportal fibrosis without bridging, consistent with the diagnosis of BA; additionally, hepatocytes with PAS-positive, diastase-resistant globules (Figure 5) were seen supporting the additional diagnosis of A1AT.
Intraoperative biopsy, hepatocytes with PAS-positive, diastase-resistant globules.
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fig5
Histopathology demonstrated bile duct proliferation (Figure 3), cholestasis (Figure 4), chronic inflammation, and periportal fibrosis without bridging, consistent with the diagnosis of BA; additionally, hepatocytes with PAS-positive, diastase-resistant globules (Figure 5) were seen supporting the additional diagnosis of A1AT.
PMC5727568_02