Stowens, Daniel
November 1959
American Journal of Gastroenterology;Nov1959, Vol. 32 Issue 5, p577
Academic Journal
Based upon data from 60 patients with congenital biliary atresia, the natural history of the disease and its variations have been outlined. Utilizing material from 230 patients, the pathologic anatomy of the disease has been described. Emphasis has been placed upon the microscopic characteristics of the hepatic component of the disease, for these provide a basis for diagnosis by needle biopsy. Histologic features in the liver by which congenital biliary atresia may be identified are: 1. disorganization of the usual hepatic lobular architecture 2. increase in size and thickness of the hepatic artery 3. absence, or abnormalities of the intrahepatic bile ducts 4. bile stasis 5. fibrosis eventuating in cirrhosis. Lesions of intrahepatic biliary atresia are to be differentiated from those of isolated stenosis of the common duct. The stenosis is a surgically correctable lesion. Needle aspiration of the liver is a good method for early diagnosis of hepatic disease in the infant and newborn. A theoretical mechanism for the pathogenesis of the disease based upon embryologic considerations is presented.


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