{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:38:04Z","timestamp":1792607884198,"version":"4.5.0"},"reference-count":11,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JPGN rep."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>An 18\u2010year\u2010old woman with congenital biliary atresia status post Kasai portoenterostomy and magnetic resonance imaging\u2010reported chronic liver disease presented at 32 weeks\u2019 gestation with 6 weeks of worsening postprandial epigastric\/right upper quadrant pain, nausea, and poor oral intake. Evaluation showed preserved hepatic synthetic function and no demonstrated clinically significant portal hypertension. Endoscopy excluded esophageal and gastric varices, computed tomography showed no imaging evidence of pancreatitis, biliary obstruction, or other acute intra\u2010abdominal pathology, computed tomography angiography excluded mesenteric ischemia, and gastric emptying scintigraphy excluded gastroparesis. Nonreassuring fetal surveillance prompted preterm induction at approximately 33 weeks 4 days. Postpartum symptoms persisted, and imaging review identified severe constipation with rectal impaction\/fecalization as the dominant treatable contributor. This case broadens the peripartum phenotype reported in native\u2010liver biliary atresia survivors by emphasizing constipation\u2010associated postprandial abdominal pain, poor oral intake, nutritional risk, and medication\u2010related bowel dysfunction rather than variceal bleeding or hepatic decompensation alone.<\/jats:p>","DOI":"10.1002\/jpr3.70253","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:51:48Z","timestamp":1791975108000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe constipation\u2010associated postprandial abdominal pain in a pregnant native\u2010liver biliary atresia survivor after Kasai portoenterostomy: A case report"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5657-1139","authenticated-orcid":false,"given":"Akram","family":"Alnounou","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Western Michigan University Homer Stryker MD School of Medicine Kalamazoo Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9238-1677","authenticated-orcid":false,"given":"Ajay","family":"Katwala","sequence":"additional","affiliation":[{"name":"College of Health Sciences Marquette University Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7981-2682","authenticated-orcid":false,"given":"Mohammad","family":"Alabbas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, and Nutrition Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6751-619X","authenticated-orcid":false,"given":"Bisher","family":"Sawaf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Toledo Medical Center Toledo Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0078-658X","authenticated-orcid":false,"given":"Arghyadeep","family":"Ganguly","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Western Michigan University Homer Stryker MD School of Medicine Kalamazoo Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9403-5970","authenticated-orcid":false,"given":"EzzElDien A.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Missouri\u2010Columbia Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6063-1558","authenticated-orcid":false,"given":"Fnu","family":"Vikash","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, and Nutrition Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cld.428"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2011.02668.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12041594"},{"issue":"11","key":"e_1_2_8_5_1","first-page":"1961","article-title":"Pregnancy in biliary atresia after Kasai operation complicated by portal hypertension","volume":"89","author":"Chiengthong K","year":"2006","journal-title":"J Med Assoc Thailand Chotmaihet thangphaet"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2005.08.026"},{"issue":"3","key":"e_1_2_8_7_1","first-page":"492","article-title":"Successful pregnancy outcome in a patient with congenital biliary atresia","volume":"80","author":"McMichens TT","year":"1992","journal-title":"Obstet 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