Biliary atresia is a serious disease which occurs in one in 10,000 children and is more common in girls than boys and in newborns of Asian and African-American than in Caucasian newborns. The cause of biliary atresia is unknown, and treatment is only partially successful.
Biliary atresia occurs due to prolonged inflammatory process that causes progressive damage to the extrahepatic biliary duct, causing bile flow resistance. Thus, biliary atresia is the absence or small lumen in part or all of extrahepatic biliary tract that causes bile flow resistance. As a result, the blood in the liver and bile salt buildup and increased direct bilirubin.
Biliary atresia is an inhibition in the pipes / ducts that carry bile from the liver to the gallbladder to. It is a congenital condition, which means that at birth.
The etiology of biliary atresia is not known with certainty. Some experts claim that genetic factors play a role, which is associated with a chromosomal abnormality trisomy 17, 18 and 21; as well as the presence of anomalous organs in 30% of cases of biliary atresia. However, most authors suggest that biliary atresia is the result of an inflammatory process that damages the biliary duct, could be due to infection or ischemia.
Some children, especially those with a fetal form of biliary atresia, often have other birth defects in the heart, spleen, or intestines.
An important fact is that biliary atresia is not a hereditary disease. Cases of biliary atresia have occurred in identical twins, where only one child with the disease. Biliary atresia is most likely caused by an event that occurs during fetal life or around the time of birth. The possibility that "triggers" may include one or a combination of the following predisposing factors:
- viral or bacterial infection
- problems with the immune system
- abnormal bile components
- errors in the development of liver and bile duct
- hepatocelluler dysfunction
- Jaundice, yellowing of the skin and eyes due to the very high levels of bilirubin (bile pigment) in the bloodstream. Jaundice is caused by an immature liver is common in newborns. It usually goes away within the first week to 10 days of life. An infant with biliary atresia usually appear normal at birth, but jaundice develops in two or three weeks after birth.
- Dark urine caused by a buildup of bilirubin (a breakdown product of hemoglobin) in the blood. Bilirubin is then filtered by the kidneys and removed in the urine.
- Pale stools, because there is no staining of bilirubin or bile into the intestine to color the stool. Also, the abdomen may become swollen due to enlargement of the liver.
- Weight loss, jaundice develops when the rate increases.
- Gradual degeneration of the liver causing jaundice, jaundice, and hepatomegaly, Channel intestine can not absorb fats and fat-soluble in water, causing malnutrition conditions, deficiency of fat-soluble in water as well as failure to thrive.
Nursing Diagnosis for Biliary Atresia
1) Hyperthermia related to inflammatory damage due to progressive extrahepatic biliary duct.
2) Ineffective breathing pattern related to an increase in abdominal distension.
3) Imbalanced Nutrition: Less Than Body Requirements related to anorexia and impaired absorption of fat.
characterized by weight loss and conjunctival pallor.
4) Impaired bowel elimination (diarrhea) related to intestinal malabsorption.
characterized by liquid stool, increased frequency of bowel movements (more than 3 times daily), increased bowel sounds.
5) Impaired skin integrity related to accumulation of bile salts in the network.
characterized by pruritis.
6) Deficient fluid volume related to nausea and vomiting.
7) Anxiety related to lack of information about the disease due to lack of knowledge.