Biliary Atresia with Cytomegalovirus Infection, Congenital Heart Disease and Pneumonia: A Case Report

Abstract

Biliary atresia (BA) is a condition of biliary obstruction. Kasai portoenterostomy (KPE) is a treatment option. The aim to determine the success rate of kasai procedure and prognosis in BA patients with other underlying diseases. This is a descriptive case study research. We report a boy, 2 months and 11 days with jaundice all over his body since one week old; putty stool, and dark urine. Old man's face, icteric, rib xylophone, subcostal retraction, rales, continuous heart murmur, and wasting. Total and direct bilirubin, SGOT, SGPT, and gamma GT are increased. A Kasai surgical procedure was carried out, but did not significantly improve his condition because the operation was performed at the age of 4 months and 8 days with liver cirrhosis, sepsis, pneumonia, and malnutrition. Cytomegalovirus (CMV) infection and acyanotic congenital heart disease also worsened his preoperative condition. Kasai portoenterostomy is a method of managing biliary atresia, but our patient was diagnosed with biliary atresia accompanied by CMV infection, congenital heart disease, or pneumonia, so the procedures not enough for this condition, and mortality rate is higher than biliary atresia alone. Age at surgery time also influences the prognosis.