Paediatric surgery: complication after Kasai operation: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: complication after Kasai operation

Sample item

Two weeks after a Kasai portoenterostomy, an infant has fever, a rising bilirubin and return of pale stools. What is the most likely complication?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Ascending cholangitis

Cholangitis is the commonest complication of the Kasai operation, because the portoenterostomy has no sphincter to prevent reflux from the Roux limb. It presents with fever, jaundice and pale stools and is treated with intravenous antibiotics. Recurrent episodes predict a poor outcome.

Option by option

  • A. Hepatic artery thrombosis

    Hepatic artery thrombosis is a complication of liver transplantation, not the Kasai operation.

  • B. Ascending cholangitis (correct)

    Correct. Ascending cholangitis is the most frequent early complication after portoenterostomy.

  • C. Portal vein thrombosis

    Portal vein thrombosis may develop later with portal hypertension but does not cause fever and recurrent pale stools early.

  • D. Anastomotic stricture of the biliary tract

    A biliary stricture is not the typical early event, because the drainage is a portoenterostomy at the porta hepatis rather than a duct anastomosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Ascending cholangitis. Cholangitis is the commonest complication of the Kasai operation, because the portoenterostomy has no sphincter to prevent reflux from the Roux limb.

Why is "Hepatic artery thrombosis" not the answer?

Hepatic artery thrombosis is a complication of liver transplantation, not the Kasai operation.

Why is "Portal vein thrombosis" not the answer?

Portal vein thrombosis may develop later with portal hypertension but does not cause fever and recurrent pale stools early.

Why is "Anastomotic stricture of the biliary tract" not the answer?

A biliary stricture is not the typical early event, because the drainage is a portoenterostomy at the porta hepatis rather than a duct anastomosis.

What concept does this question test?

It tests Paediatric surgery: complication after Kasai operation in General Surgery. It presents with fever, jaundice and pale stools and is treated with intravenous antibiotics. Recurrent episodes predict a poor outcome.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: complication after Kasai operation?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.