Case 125

Medical History

A two-month-old female child was admitted at an emergency department for persistent jaundice, acholic stools and choluria. Laboratorial data included: hemoglobin: 8.11; hematocrit: 22.8, gammaglutamyl transferase: 1262; alkaline phosphatase: 612; aspartate aminotransferase: 105; alanine aminotransferase: 33; total bilirubin: 5.4; direct bilirubin 3.8. On physical examination, she presented mucosal pallor, enlarged abdomen, a liver edge palpable 6 cm below the right costal margin and mild splenomegaly. An abdominal ultrasonography (US) was then requested.

Image 1: Doppler scan of the portal bifurcation.


Image 2: A right upper quadrant US view showing the gallbladder.


Image 3: A left upper quadrant US view showing the spleen.

Which is the standard management for this condition?

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