Muhammad Asif Qureshi, Mehmood Shaukat.
Biliary Atresia: Liver histology and its` relation to the age of the patient.
Pak Paed J Nov ;30(4):193-6.

Background: There are gross and histological changes in liver with increasing age in patients with biliary atresia. These changes have inverse relation to the outcome after surgery. There are geographical differences in the histological changes and severity as well as outcome of patients with biliary atresia. This study determines the histological changes in liver biopsy specimen taken during surgery on patients with biliary atresia from various age groups. No such data on Pakistani population is available. Methods: All children, total number 42, with age from one month and above, diagnosed to have biliary atresia, were studied. It is a single center, prospective, interventional study over a period of 5 years. Spearman correlation was used to find a correlation between the age of the patient and severity of histological variables. Results: The only constant histological finding that evolved with increasing age was cirrhosis of liver. It was not present up to the age of 2 months. 57.1% of patients from 2 months to 2.5 months and 62.5% of patients up to the age of 3 months had cirrhosis of liver. It was statistically significant with a p value =0.004. Other statistically significant variables were, portal fibrosis with a p value =0.005, bile duct proliferation with a p value =0.002 and portal cholestasis with a p value =0.024. Onset of cirrhosis impairs the prospects of a good recovery. Conclusion: Significant changes take place in liver histology in patients with biliary atresia with increasing age .Early diagnosis and prompt treatment is necessary for a satisfactory outcome. The findings in our population are very similar to the results by many other workers and the onset of cirrhosis appears to be rather earlier in this small group of patients.

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