title: Antenatally detected cystic biliary atresia: differential diagnoses of a double bubble.
abstract: The 'double bubble' sign on antenatal ultrasound is often associated with duodenal atresia although there are numerous causes. We present a case of cystic biliary atresia presenting with a "double bubble" at 36-weeks gestation. Postnatal ultrasound and MRCP confirmed a cystic lesion at the porta hepatis, mandating early laparotomy and a successful Kasai portoenterostomy. Although diagnosis of such lesions may be imprecise antenatally, awareness and detection does allow early postnatal investigation and management, which is vital to optimise outcome. This case highlights the need to be mindful of other important anomalies that can give this appearance and that may require early intervention.
authors.affiliation: Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Eastern Road, Brighton, BN2 5BE England.
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Adewole
authors.affiliation: Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Eastern Road, Brighton, BN2 5BE England.
authors.forename: Naomi J
authors.initials: NJ
authors.lastname: Wright
authors.affiliation: Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Eastern Road, Brighton, BN2 5BE England.
authors.forename: Ruth
authors.initials: R
authors.lastname: Hallows
authors.affiliation: Department of Paediatric Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Davenport
keywords: Antenatal ultrasound; Cystic biliary atresia; “double bubble”
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