Diseases and conditions

What is a pediatric biliary-enteric stricture?

Various diseases can cause liver failure but, fortunately, modern treatments allow physicians to transplant livers into children, offering the opportunity for a long and healthy life. One of the most common problems that can develop following liver transplantation is a biliary-enteric stricture—a narrowing or blockage of the passages that drain bile from liver cells to the small intestine.

Symptoms of biliary-enteric stricture include pain, chills, fever, jaundice (yellowed skin), itching, nausea, vomiting and pale stool. In addition to blood tests and imaging with MRI, interventional radiologists can also find blockages using X-ray imaging and dyes to pinpoint and identify any problems in the biliary system.

Doctor and child look at image

How do IRs treat pediatric biliary-enteric stricture?

Transhepatic balloon dilation is safe and effective for the treatment of bile duct narrowing in children and occurs in two phases. The first step to successfully opening the bile passages is to temporarily insert a tube into the liver and drain the backed-up fluid. An interventional radiologist passes a needle through the skin and into the liver, using ultrasound and X-ray for guidance. Once there, the doctor uses contrast dye to watch the flow of bile through the ducts and pinpoints the problem area. The congestion in the liver is relieved by allowing the fluid to drain through the tube and out of the body.

Happy child on parent's lap

In the second phase, for a more long-term solution, the bile ducts are opened over the course of multiple sessions (usually two to three). Using image-guided techniques, tiny balloons are directed to the strictures, where they are carefully inflated to open the narrowed passage. Once the IR determines that this balloon therapy is assisting the normal flow of bile, the temporary tube is removed. To ensure that the bile duct remains open, the interventional radiologist will repeat imaging scans during follow-up appointments.

Disclaimer: SIR is providing this information as a public service. SIR assumes no liability, legal, financial or otherwise for the accuracy of this information or the manner in which it is used. SIR does not offer medical advice. This information is being provided for informational purposes only and should not be used to replace professional medical advice. It is best to seek advice and attention from your physician or qualified health care professional.

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Pediatric biliary-enteric strictures

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