Contribution of Ultrasound in the Diagnosis of Biliary Atresia in Mali

Introduction: Biliary atresia is a congenital malformation resulting from an inflammatory, destructive and sclerosing process, affecting the intra and extra hepatic bile ducts. It is the leading surgical cause of neonatal cholestasis and liver transplantation in children, of poorly understood etiology. Clinical diagnosis is suggested by jaundice, discolored stools and dark urine. Ultrasound is essential for diagnosis. The objective is to study the contribution of ultrasound in diagnosis. Materials Methods: This was a retrospective and prospective bi-center cross-sectional study (CHU-Luxemburg and CHU-Kati) carried out from January 2019 to May 2022, i.e. 41 months. The equipment used was branded devices: EDAN and MINDRAY equipped with three probes with Doppler. Results: A total of 8 cases out of 2200 pediatric ultrasounds from 0-06 months, representing a frequency of 0.36%. The average age was 45.5 days with extremes of 07-90 days. The age group 08-28 days was more represented (62.5%), the sex ratio was 0.6. All patients were jaundiced with biological cholestasis. The bile ducts were absent on ultrasound in all patients; the gallbladder was present in two patients, with an interruption of the gallbladder lumen in one patient and the presence of a cord sign (37.5%). Management was surgical. Conclusion: Biliary atresia is a rare condition. Prenatal ultrasound diagnosis is exceptional; in our setting, it is made after birth. Treatment is surgical.