Recommended management strategies for a neonate diagnosed with biliary atresia focus on early diagnosis and prompt surgical intervention to improve outcomes. The primary treatment is the Kasai portoenterostomy, ideally performed before 8 weeks of age, to restore bile flow and prevent progressive liver damage NICE CG98. Supportive care includes managing cholestasis symptoms, optimizing nutrition with fat-soluble vitamin supplementation, and monitoring for complications such as portal hypertension and liver failure NICE CG98. If Kasai surgery is unsuccessful or if liver disease progresses, timely referral for liver transplantation is essential NICE CG98. Recent literature emphasizes the importance of early detection through neonatal screening and suggests adjunct medical therapies to manage cholestasis, although these are not yet standard practice Ramachandran et al. 2015Heinz & Vittorio 2023Gorbatyuk & Kurylo 2024. Multidisciplinary care involving paediatric surgeons, hepatologists, dietitians, and specialist nurses is critical to optimize long-term outcomes NICE CG98.
Key References
- CG98 - Jaundice in newborn babies under 28 days
- (Ramachandran et al., 2015): Recent Trends in the Diagnosis and Management of Biliary Atresia in Developing Countries.
- (Heinz and Vittorio, 2023): Treatment of Cholestasis in Infants and Young Children.
- (Gorbatyuk and Kurylo, 2024): Biliary atresia in children (analytical literature review and review of own observation).