Bile Atresiaaa

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    BILE ATRESIAGROUP II

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    INTRODUCTION

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    HISTORY OF BILARY ATRESIA

    Biliary atresia is one of the mostdistressing surgical diseases of infancy.

    1955 - more than 30years ago, a 72-

    day-old girl was successfully treatedby hepatic portoenterostoy attohokou i\university hospital in sendaiin northern japan

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    INCIDENCE

    Incidence of biliary atresia ishighest in Asian populations.The disorder also occurs inblack infants, with an incidence

    approximately 2 times higherthan that observed amongwhite infants.

    Extrahepatic biliary atresia is

    more common in females thanin males

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    INCIDENCE

    Biliary atresia is a disorder

    unique to the neonatal

    period. The fetal/perinatal

    form is evident within thefirst 2 weeks of life; the

    postnatal type presents in

    infants aged 2-8 weeks

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    OVERVIEW

    WHAT IS BILIARY ATRESIA? Biliary atresia is a chronic,

    progressive liver problem thatbecomes evident shortly after

    birth. If your child has biliary atresia,her common bile duct is blockedor damaged, so that itsimpossiblefor bile to flow through it, just as itshard for water to pass through a

    clogged pipe. This is calledcholestasis,or poor bile flow, andquickly leads to malnutrition andliver damage.

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    OVERVIEW

    The exact cause of biliary

    atresia is not known.

    Caregivers are certain that

    this disease is not inherited.The bile ducts are believed

    to be damaged before or

    shortly after your baby's

    birth.

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    OVERVIEW

    The following are possible

    causes of biliary atresia:

    Autoimmune diseases

    Developmental defects

    Infections

    Toxins

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    ANATOMY & PHYSIOLOGY

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    ANATOMY & PHYSIOLOGY

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    ANATOMY & PHYSIOLOGY

    Functions of the biliary system

    The biliary system's mainfunction includes the following: To drain waste products from the liver

    into the duodenum

    To help in digestion with the controlledrelease of bile

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    ANATOMY & PHYSIOLOGY

    Bile is the greenish-yellow fluid(consisting of waste products,cholesterol, and bile salts) thatis secreted by the liver cells to

    perform two primary functions,including the following: To carry away waste

    To break down fats during digestion

    Bile salt is the actual componentwhich helps break down and absorbfats. Bile, which is excreted from thebody in the form of feces, is what givesfeces its dark brown color.

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    SIGN AND SYMPTOMS

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    SIGN AND SYMPTOMS

    Jaundice (yellowing of the skin or thewhites of the eyes) is the mostimportant sign of biliary atresia. Thismay appear shortly after birth or from2 to 8 weeks after birth. Your baby

    may also have one or more of thefollowing:

    Abdominal (belly) pain orenlargement.

    Dark or cola-colored urine.

    Discomfort or irritability.

    Itchiness.

    Weight loss or poor growth.

    White, gray, or clay-colored stools.

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    SIGN AND SYMPTOMS

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    DIAGNOSTIC AND LABORATORY EXAM

    Blood and urine tests

    Imaging tests:

    Abdominal ultrasound

    Abdominal x-rays Cholangiogram

    Liver and gallbladder scan

    Scintigraphy.

    Liver biopsy

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    NURSING DIAGNOSIS

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    NURSING DIAGNOSIS

    1. Fluid volume deficit r/t poorabsorption

    2. Potential for altered growth-due toliver disease

    3. Altered growth and development r/tchronic illness

    4. Knowledge deficit r/t homecareinstructions

    5. Health maintenance altered, need

    for family to monitor for symptoms ofincreased liver dysfunction

    6. Grieving, anticipatory

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    MANAGEMENT

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    MANAGEMENT

    Medicine

    Your baby may need one ormore of the following:

    Antibiotics

    Anti-itching medicine:

    Biliary agents

    Diuretics

    Steroids

    Vitamin supplements andspecial formulas

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    MANAGEMENT

    Treatment for biliary atresia aims torestore a normal bile flow, to relievesymptoms, and prevent seriousproblems.

    Caregivers may do a surgery to makean open bile duct so bile can drainfrom the liver. Success is more likely ifthis surgery is done before the baby istwo months old. If this surgery fails, aliver transplant may be needed. This is

    done by removing your baby's wholeliver, or a part of your baby's liver, andreplacing it with a healthy, donatedliver.

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    DISCHARGE PLANNING

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    DISCHARGE PLANNING

    Medications: Take medications that are prescribed by

    the physician at the right time with a

    correct dose and dosage.

    Exercise and Activity: Your baby should rest as much as possible

    and get plenty of sleep.

    Treatment

    Encourage mother or relatives to handwash before and after feeding the baby

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    DISCHARGE PLANNING

    Health Teaching

    Teach mother or relatives inproper hand washing technique

    Keep child out of polluted

    environment.

    Outpatient

    Keep appointments for health

    care.

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    DISCHARGE PLANNING

    Diet

    A caregiver, called a dietitian, may talk to youabout your baby's feeding and nutrition. Adietitian can help you to increase the amount ofcalories your baby gets. You may also discuss withhim if it is OK to breastfeed your baby or what milkyou should feed him.

    Ask your baby's caregiver about high-calorieliquid feedings. These are given through a tubecalled a nasogastric (NG) tube.

    Give your baby a good, well-balanced diet tohelp him feel better, have more energy, and healfaster. If your baby is able to eat normally, let himeat a variety of healthy foods. These may include

    fruits, vegetables, dairy products, or other babyfoods.

    Special formulas or oils may be added to yourbaby's foods or liquids. These may add extracalories to help him grow.

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    DISCHARGE PLANNING

    Spiritual Counseling

    Remind patient to alwaysput God first in everything hedoes and leave his illness inHis hands

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    THANK YOU!