Diagnostic Problems in Infantile Cholestatic Jaundice

Authors

  • Sukawat Watanatittan Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand
  • Thongkao Rattanasuwan Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand
  • Rangsan Niramis Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand
  • Veera Buranakitjaroen Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand
  • Maitree Anuntkosol Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok 10400, Thailand

Abstract

                A diagnostic laparotomy was retrospectively assessed for reliability in 173 infants, between 1-4 months of age, who were treated at the Children's Hospital during 1990-1995. Cases of cholestatic jaundice associated with sepsis or concomitant administration of parenteral nutrition were not included in the study. Data from this study supported the reliability of the criteria. If these criteria were strictly followed, none of the inf ants with biliary atresia (BA) in this study would be missed. However, about 25 per cent of infants with neonatal hepatitis (NH) would have to be subject to a diagnostic laparotomy.

                It is concluded that any infant with cholestatic jaundice and acholic stool should undergo a diagnostic laparotomy at the age of 2 months if total serum bilirubin is 6-25 mg/dl, unless there is a steady decrease of serum bilirubin and the cause of jaundice is documented by other laboratory investigations and clinical evidences. Those who have a positive serology test for syphilis should be treated accordingly and closely ed. If the infants' jaundice and stool colour are not improved in an expected timing and should also undergo a diagnostic laparotomy. Radionuclide hepatobiliary scan needs further assessment for its sensitivity. If this test can be proved to have a 100 per cent sensitivity, it could be included in the screening criteria. UItrasonographic study should be done in every case in order to detect choledochal cyst, but not to differentiate NH from BA.

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Published

1998-06-30

How to Cite

1.
Watanatittan S, Rattanasuwan T, Niramis R, Buranakitjaroen V, Anuntkosol M. Diagnostic Problems in Infantile Cholestatic Jaundice. Thai J Surg [Internet]. 1998 Jun. 30 [cited 2024 Apr. 26];19(2):45-50. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/250008

Issue

Vol. 19 No. 2 (1998): April - June

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.