1. Fight Infection in the Bile Ducts
The child is most susceptible to infection directly following Kasai surgery for biliary atresia. The most common concern is the development of ascending cholangitis. This bacterial infection occurs when bacteria normally in the small intestine "ascends" to the biliary tree. Parents need to consult a physician if the child develops a fever with no other symptoms, more jaundice than is normal for their child and if her stools lighten in color. Treatment for this type of complication is intravenous antibiotics followed by a regimen of oral antibiotics.
2. Treat Skin Conditions Following Surgery
Often a child that has undergone the Kasai surgery continues to experience a degree of jaundice. This can be treated with phenobarbital prescribed by the child's physician. Another skin condition that can worsen following the Kasai procedure is itching. To treat intolerable itching, many doctors prescribe cholestyramine and ursodeoxycholic acid. These medications generally relieve the problem.
3. Relieve Problems Caused by Cirrhosis
Despite having the Kasai procedure, liver cirrhosis is likely to occur at some point in the child's life. Cirrhosis itself poses many complications that require treatment. Often changes in blood flow from the liver to the intestines occur in these children. Results that can happen due to these changes are nosebleeds, enlarged veins and body fluid retention. If there is significant bleeding in the intestines or stomach, a sclerosing (hardening) agent may be injected directly into the enlarged veins. In some situations, blood vessels in the esophagus or stomach begin to leak, causing an emergency. In general the child will vomit up a great deal of blood and needs immediate medical attention to stop the bleeding. Typically excessive body fluid can be managed with diuretics. Ascites is another complication that can arise with cirrhosis. This involves the collecting of fluid in the child's belly. The physician will likely prescribe a special medicine that helps the child excrete the excessive fluid.
