The role of indocyanine green in the diagnosis of biliary atresia: A word of caution

Indocyanine green (ICG) fluorescence imaging has emerged as a potential tool in evaluating biliary atresia, offering real-time visualisation of hepatobiliary excretion. Following intravenous administration, ICG is taken up by hepatocytes and excreted into bile, allowing assessment of biliary patency. In biliary atresia, absent or delayed fluorescence in the intestine may suggest obstruction. However, its diagnostic utility should be used with caution. We present a case highlighting a potential flaw in using ICG to diagnose biliary atresia.