PATIENTS'S NAME Gaia Bianca Magtibay Pasamba PARENTS Giorde C. Pasamba Lilibeth Magtibay- Pasamba DATE OF BIRTH June 7, 2005 PLACE OF BIRTH The Medical City, Pasig City, Philippines

July 2, 2005 - Bilirubin test: Total (17.8) Direct (3.4) Indirect (14.4)
July 10, 2005 - Urobilinogen test: Negative
July 11, 2005 - Liver, gallbladder and billiary tree sonogram.

Conclusion: Contracted gallbladder. Normal liver and biliary tree.

July 19, 2005 - Hepatobiliary Imaging. Conclusion: Normal liver size; no intrahepatic focal lesion. Non visualizing gallbladder and proximal small bowels as described, compatible with cholestasis. Considerations include severe hepatocellualar disease, bile-plug syndrome or biliary atresia. A repeat study after Phenobarbital premedication is suggested.
July 25, 2005 - Bilirubin test: Total (3.22) Direct (3.03) Indirect (0.19)
August 1, 2005 - Repeat Hepatobiliary Imaging. Conclusion: Normal liver size; no intrahepatic lesion. Non visualizing gallbladder and proximal bowels, as described, compatible with cholestasis, (hepatocellular disease vs biliary atresia). Tissue correlation is suggested.
August 5, 2005 - Bilirubin test: Total ( 6.21) Direct ( 5.24) Indirect (0.97)
August 13, 2005 - Bilirubin test: Total (6.18) Direct (5.28) Indirect (0.9)
August 15, 2005 - Liver Biopsy: Final histopathological diagnosis: Consistent with obstructive cholangiopathy. Extrahepatic Biliary Atresia vs Scherosing Cholangitis correlate clinically.
August 20, 2005 KASAI procedure was performed at the Philippine General Hospital. Surgical Pathology Report:

A) Consistent with Extrahepatic Biliary Atresia.
B) Hypoplastic Gallbladder.

October 29, 2005 - Bilirubin Test: Total (5.43), Direct (4.67) Indirect (0.78)
December 03 2005 - Bilirubin Test: Total (10.57), Direct (9.69), Indirect (0.88)
Weight as of December 3, 2005 : 6.8 kgs

Born full term via cesarean section. Birth weight of 2.720 kg and birth length of 52 cm.

Purely breastfed for the first 2 months. Prescribed with Enfalac but had allergic reaction. Shifted to Isomil. After KASAI procedure, was placed on ALFARE.

Started eating solid food Nov. 2005 (rice cereals)

Hepatitis B - 2x, BCG, Pentahib - 3x

Phenobarbital gr ½ , 1 tablet
Ursodeoxycholic Acid 125 mg 1 day
Vitamin K 2mg/o.2ml
Vitamin E 100 1 cap of 3 days
Clusivol drops 0.6ml/day
Trimethoprim Sulfa 400/80 1.2ml/day