Purpose or Case Report: The aim of this exhibit is to review imaging findings of neonatal biliary disease, with emphasis on biliary atresia and conditions of surgical interest. We will present a series of cases on cholestatic diseases encountered in the neonatal period and multi-modality approach to imaging these patients.

Methods & Materials: Neonatal biliary disease is an important source of morbidity in the pediatric population. Most cholestatic disease processes are classified as either obstructive or hepatocellular in origin, which crucially determines the surgical or non-surgical nature of effective treatment. In particular, biliary atresia requires time sensitive intervention to avoid cirrhosis and death. Ultrasound and nuclear biliary scintigraphy play a key role in screening and diagnosis of cholestatic diseases, and MDCT and liver MRI are supplementary in evaluation of surgical planning and complications.
We will use a case based approach to discuss the following neonatal cholestatic diseases and related conditions of surgical interest:
Biliary atresia
Neonatal hepatitis
Choledochal cyst
Alagille syndrome
Neonatal hemochromatosis
Inspissated bile syndrome
Cholelithiasis
Portosystemic shunt
Portal vein thrombus
Hepatic artery anomalies
Post-Kasai intrahepatic biliary cysts
Post-Kasai hepatic nodules
Results:
Conclusions: Imaging based diagnosis is crucial to the proper management of neonatal biliary disease. Definitive diagnosis and understanding of surgical and non-surgical complications are necessary to reduce morbidity from these similarly presenting diseases.