Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Hepatol. Oct 27, 2012; 4(10): 284-287
Published online Oct 27, 2012. doi: 10.4254/wjh.v4.i10.284
Hepatic osteodystrophy complicated with bone fracture in early infants with biliary atresia
Tadao Okada, Shohei Honda, Hisayuki Miyagi, Masashi Minato, Akinobu Taketomi
Tadao Okada, Shohei Honda, Hisayuki Miyagi, Masashi Minato, Department of Pediatric Surgery, Hokkaido University Hospital, Sapporo 060-8648, Japan
Akinobu Taketomi, Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
Author contributions: Okada T contributed to study concept and design, acquisition of data, analysis and interpretion of data, drafting of manuscipt; Honda S, Miyagi H and Minato M contributed to study supervision; Taketomi A contributed to critical revision of the manuscript for important intellectual content.
Correspondence to: Tadao Okada, MD, Department of Pediatric Surgery, Hokkaido University Hospital, Kita-ku, Kita 14, Nishi 5, Sapporo 060-8648, Japan.
Telephone: +81-11-7067381 Fax: +81-11-7067384
Received: November 24, 2011
Revised: September 15, 2012
Accepted: October 26, 2012
Published online: October 27, 2012

Biliary atresia (BA) is one of the major hepatobiliary abnormalities in infants and one of the causes of hepatic osteodystrophy. Bone disease may be caused by the malabsorption of calcium and magnesium by vitamin D in hepatobiliary diseases in which bile flow into the intestines is deficient or absent. Bone fracture before Kasai hepatic portoenterostomy or within one month after the procedure in an infant with BA is very rare. We herein report two infants: one infant with BA who initially presented with a bone fracture before Kasai hepatic portoenterostomy, and the other at 4 wk after Kasai hepatic portoenterostomy, and also provide a review of the literature. Moreover, we conclude that clinicians should consider BA in infants with bone fracture during early infancy.

Keywords: Biliary atresia, Bone fractur, Hepatic osteodystrophy, Kasai hepatic portoenterostomy, Vitamin D deficiency