1. Perform a Close Physical Inspection
Infants with biliary atresia typically appear normal at birth but begin to show symptoms of the disorder between two weeks and two months of age. The most noticeable physical sign is jaundice, a yellowing of the skin and whites of the eyes. Jaundice appears due to an extreme level of bile pigment called bilirubin in the bloodstream. Do not be alarmed if this symptom is present at birth as it generally indicates an immature liver, often seen in neonates. Watch instead for the "yellowing" to begin at around two weeks of age. Other physical signs of biliary atresia include dark urine and foul-smelling pale stools that float in water. As the condition worsens, you will often find a hardening area which can be felt in the abdomen. The child will also exhibit a slow growth weight and little, if any, weight gain.
2. Run Specific Fluid Tests
Physicians often assess children suspected to be suffering from biliary atresia with fluid tests. Usually, a blood test is performed to determine whether there is an unusual amount of bilirubin, the presence of which indicates liver dysfunction. Also, a test referred to as a HIDA scan may be run. In this procedure a radioactive dye that acts in a manner similar to bilirubin is introduced into the infant's bloodstream. When biliary atresia is present, the dye travels to the liver but does not flow through the biliary system due to the damaged ducts.
3. Help Determine Condition Through Imaging Tests
Many imaging tests can be used to help identify biliary atresia. An ultrasound test often reveals a small or completely absent gall bladder while also providing images of the liver and bile ducts. X-rays of the abdomen may be run as well. These can show an enlarged liver and spleen and possibly blocked intestines. The Cholangiogram test is specific for showing whether the bile ducts are open. In this procedure, dye is injected into the infant's gallbladder (if present) where it travels to the bile ducts. An x-ray is then used to determine if the there is normal flow to the small intestines and liver. Another test referred to as an HIDA scan also uses a special dye to highlight images of the liver and gallbladder to determine how they are functioning. Finally, a scintigraphy may be performed to give physicians a look at the flow of blood through the baby's bile ducts and liver.
4. Use a Biopsy to Discover Disorder
When fluid and imaging tests point to the possibility of biliary atresia, a liver biopsy is performed. This reliable test involves the insertion of a needle into the infant's liver. An ultrasound is used to guide the physician in needle placement. A very small sample of the liver is extracted from which laboratory tests are run. These tests are often definitive for biliary atresia.
