Female patient hospitalized at four months of age for fever and sensory depression.
Background: full term newborn, with adequate weight for gestational age, diagnosed with seizures due to ABO incompatibility, treated with luminotherapy within the first 24 h of life.
At the time of diagnosis, total bilirubin levels were 9.9 mg/dl and direct bilirubin levels were 0.5 mg/dl. The patient was readmitted to Neonatology after one month of life due to prolonged jaundice.
During hospitalization, an abdominal ultrasound was performed, which reported the presence of intrahepatic and extrahepatic bile ducts, without dilatation.
Laboratory: Total bilirubin 11.3 mg/dl and direct bilirubin 1.7 mg/dl, FAL 257 IU/L, TGP 55 IU/L, GDT 69 IU/L. The patient was followed up by an outpatient gastroenterologist until discharge.
Elevated liver function tests at admission revealed generalized jaundice, hepatomegaly and drowsiness.
Within the first 24 h of hospitalization, the patient presented a focal seizure episode in the right hemibody; a subdural hematoma was found in the computed tomography (CT) that required surgical drainage and mechanical ventilation up to 48 h after surgery.
Laboratory at admission: GOT 120 IU/L, GPT 180 IU/L, FAL 1053 IU/L, gamma-glutamyltransferase 59%, leflunose 1119 IU/L, LDH 1262 mg/dl prior frozen sample,
Serology for HIV, syphilis, toxoplasmosis, hepatitis B, hepatitis A and cytomegalovirus negative.
A scintigraphy showing intrahepatic and extrahepatic contrast uptake showed no passage of contrast to the intestine.
We decided to perform laparoscopic portoenterostomy after confirming the diagnosis of biliary atresia during surgery.
At 6 months of life he had neurological maturation appropriate to his age.
He required liver transplantation near one year old.
