A rare complication in an adult patient after Kasai portoenterostomy for biliary atresia.

Kasai portoenterostomy has significantly prolonged the survival of patients with biliary atresia not undergoing liver transplantation. However, patients develop complications at some point during their life. The development of hepatocellular carcinoma is a very rare complication and has never been reported till date in the adult population. We report a case of development of hepatocellular carcinoma in a patient who had the Kasai procedure done for biliary atresia. It can pose a diagnostic and therapeutic challenge to physicians and delay in diagnosis is common in such patients, which can lead to grave consequences. We suggest that strict recommendations be made to avoid delays in the diagnosis of hepatocellular carcinoma, by intensifying screening in this group of patients by optimum use of magnetic resonance imaging (MRI).