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BILE ATRESIAGROUP II
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INTRODUCTION
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HISTORY OF BILARY ATRESIA
Biliary atresia is one of the mostdistressing surgical diseases of infancy.
1955 - more than 30years ago, a 72-
day-old girl was successfully treatedby hepatic portoenterostoy attohokou i\university hospital in sendaiin northern japan
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INCIDENCE
Incidence of biliary atresia ishighest in Asian populations.The disorder also occurs inblack infants, with an incidence
approximately 2 times higherthan that observed amongwhite infants.
Extrahepatic biliary atresia is
more common in females thanin males
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INCIDENCE
Biliary atresia is a disorder
unique to the neonatal
period. The fetal/perinatal
form is evident within thefirst 2 weeks of life; the
postnatal type presents in
infants aged 2-8 weeks
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OVERVIEW
WHAT IS BILIARY ATRESIA? Biliary atresia is a chronic,
progressive liver problem thatbecomes evident shortly after
birth. If your child has biliary atresia,her common bile duct is blockedor damaged, so that itsimpossiblefor bile to flow through it, just as itshard for water to pass through a
clogged pipe. This is calledcholestasis,or poor bile flow, andquickly leads to malnutrition andliver damage.
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OVERVIEW
The exact cause of biliary
atresia is not known.
Caregivers are certain that
this disease is not inherited.The bile ducts are believed
to be damaged before or
shortly after your baby's
birth.
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OVERVIEW
The following are possible
causes of biliary atresia:
Autoimmune diseases
Developmental defects
Infections
Toxins
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ANATOMY & PHYSIOLOGY
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ANATOMY & PHYSIOLOGY
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ANATOMY & PHYSIOLOGY
Functions of the biliary system
The biliary system's mainfunction includes the following: To drain waste products from the liver
into the duodenum
To help in digestion with the controlledrelease of bile
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ANATOMY & PHYSIOLOGY
Bile is the greenish-yellow fluid(consisting of waste products,cholesterol, and bile salts) thatis secreted by the liver cells to
perform two primary functions,including the following: To carry away waste
To break down fats during digestion
Bile salt is the actual componentwhich helps break down and absorbfats. Bile, which is excreted from thebody in the form of feces, is what givesfeces its dark brown color.
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SIGN AND SYMPTOMS
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SIGN AND SYMPTOMS
Jaundice (yellowing of the skin or thewhites of the eyes) is the mostimportant sign of biliary atresia. Thismay appear shortly after birth or from2 to 8 weeks after birth. Your baby
may also have one or more of thefollowing:
Abdominal (belly) pain orenlargement.
Dark or cola-colored urine.
Discomfort or irritability.
Itchiness.
Weight loss or poor growth.
White, gray, or clay-colored stools.
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SIGN AND SYMPTOMS
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DIAGNOSTIC AND LABORATORY EXAM
Blood and urine tests
Imaging tests:
Abdominal ultrasound
Abdominal x-rays Cholangiogram
Liver and gallbladder scan
Scintigraphy.
Liver biopsy
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NURSING DIAGNOSIS
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NURSING DIAGNOSIS
1. Fluid volume deficit r/t poorabsorption
2. Potential for altered growth-due toliver disease
3. Altered growth and development r/tchronic illness
4. Knowledge deficit r/t homecareinstructions
5. Health maintenance altered, need
for family to monitor for symptoms ofincreased liver dysfunction
6. Grieving, anticipatory
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MANAGEMENT
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MANAGEMENT
Medicine
Your baby may need one ormore of the following:
Antibiotics
Anti-itching medicine:
Biliary agents
Diuretics
Steroids
Vitamin supplements andspecial formulas
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MANAGEMENT
Treatment for biliary atresia aims torestore a normal bile flow, to relievesymptoms, and prevent seriousproblems.
Caregivers may do a surgery to makean open bile duct so bile can drainfrom the liver. Success is more likely ifthis surgery is done before the baby istwo months old. If this surgery fails, aliver transplant may be needed. This is
done by removing your baby's wholeliver, or a part of your baby's liver, andreplacing it with a healthy, donatedliver.
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DISCHARGE PLANNING
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DISCHARGE PLANNING
Medications: Take medications that are prescribed by
the physician at the right time with a
correct dose and dosage.
Exercise and Activity: Your baby should rest as much as possible
and get plenty of sleep.
Treatment
Encourage mother or relatives to handwash before and after feeding the baby
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DISCHARGE PLANNING
Health Teaching
Teach mother or relatives inproper hand washing technique
Keep child out of polluted
environment.
Outpatient
Keep appointments for health
care.
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DISCHARGE PLANNING
Diet
A caregiver, called a dietitian, may talk to youabout your baby's feeding and nutrition. Adietitian can help you to increase the amount ofcalories your baby gets. You may also discuss withhim if it is OK to breastfeed your baby or what milkyou should feed him.
Ask your baby's caregiver about high-calorieliquid feedings. These are given through a tubecalled a nasogastric (NG) tube.
Give your baby a good, well-balanced diet tohelp him feel better, have more energy, and healfaster. If your baby is able to eat normally, let himeat a variety of healthy foods. These may include
fruits, vegetables, dairy products, or other babyfoods.
Special formulas or oils may be added to yourbaby's foods or liquids. These may add extracalories to help him grow.
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DISCHARGE PLANNING
Spiritual Counseling
Remind patient to alwaysput God first in everything hedoes and leave his illness inHis hands
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THANK YOU!