When a Kasai portoenterostomy goes wrong

The first job Archivist had in paediatrics was working as an SHO on the gastroenterology ward in a children’s hospital in Manchester. There were rows of children with biliary atresia, small for their age, jaundiced with large swollen abdomens usually post Kasai portoenterostomy (KPE) or a few waiting to go for surgery. Pale white stools, once seen, will never be forgotten. Post-surgery, we were waiting for the jaundice to clear a sign of success and a failed Kasai operation meant liver transplant.

The first liver transplant in children was in 1963 which was unfortunately unsuccessful. Fortunately, now, graft …

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