Umbilical hernia and clinical course of patients with bile duct atresia.

BACKGROUND

Bile atresia is children's leading cause of cirrhosis. Its high morbidity and mortality are explained by its complications, including gastrointestinal bleeding and portal hypertension. Umbilical hernia has been embryologically and clinically associated with portal hypertension and cirrhosis; however, the clinical evolution of patients with bile atresia and umbilical hernia is unknown, so the aim of the study is to describe this link.

OBJECTIVE

To determine the prevalence of the coexistence of AVB and HU in patients in a tertiary hospital, and describe the clinical evolution of these patients with respect to the presence/absence of HU as a strategy in the search for prognostic factors of morbidity and mortality.

MATERIAL AND METHODS

This is an observational, descriptive, retrospective, and longitudinal study that included patients with bile atresia in a tertiary pediatric hospital. The variables related to bile atresia were analyzed, and the clinical evolution was described according to the presence or absence of UH.

RESULTS

56 patients with bile atresia were included, of which 69.6% were females. Portal hypertension occurred in 80.4%, with the presence of collateral venous network, gastrointestinal bleeding, ascites, and hepatomegaly being the indirect clinical data most often presented. The frequency of coexistence of umbilical hernia and bile atresia was 75%. Portal hypertension, collateral venous network, gastrointestinal bleeding, ascites, and small esophageal varices were the significantly more prevalent variables in patients with umbilical hernia.

CONCLUSIONS

Patients with bile atresia have a greater possibility of developing umbilical hernia and that it is associated with a more advanced evolution of portal hypertension and its associated signs and complications.