SavedAdd your journal

Journals / Turkish Journal of Gastroenterology / 2016 / Cilt: 27 - Sayı: 1

Clues to the diagnosis of biliary atresia in neonatal cholestasis

Mehmet AĞIN
GÖKHAN TÜMGÖR
Murat ALKAN
ÖNDER ÖZDEN
MEHMET SATAR
Recep TUNCER
Pages
37–41
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

We recommend that intraoperative cholangiography should be performed without waiting for further test results when a neonate or infant presents with acholic stool, high GGT values, and absent or small gallbladder on abdominal USG

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Background/Aims: The purpose of this study was to identify important clues in differentiating biliary atresia (BA) from causes of neonatal cholestasis other than BA (non-BA) and establishing the reliability of current tests.Materials and Methods: Thirty-four patients with BA and 27 patients with non-BA cholestasis being monitored at the Çukurova University Medical Faculty, the Pediatric Gastroenterology Department and the Pediatric Surgery Department between 2009 and 2015 were retrospectively assessed.
📊
Key Findings & Data:The highest positive predictive value and specificity was determined for a GGT level greater than 197 in addition to absent or small gallbladder on USG and acholic stool in the BA group.
💡
Conclusion & Impact:We recommend that intraoperative cholangiography should be performed without waiting for further test results when a neonate or infant presents with acholic stool, high GGT values, and absent or small gallbladder on abdominal USG
🔬Design:Research Article
📍Scope:2009 Verileri
⚙️Variables:Domain Parameters

Özet

Background/Aims: The purpose of this study was to identify important clues in differentiating biliary atresia (BA) from causes of neonatal cholestasis other than BA (non-BA) and establishing the reliability of current tests.Materials and Methods: Thirty-four patients with BA and 27 patients with non-BA cholestasis being monitored at the Çukurova University Medical Faculty, the Pediatric Gastroenterology Department and the Pediatric Surgery Department between 2009 and 2015 were retrospectively assessed. Results: Cases of early onset jaundice, acholic stool, gamma-glutamyl transferase (GGT) elevation, and absent or small gallbladder on ultrasonography (USG) were greater in the BA group, while the levels of consanguinity and splenomegaly were higher in the non-BA group. The highest positive predictive value and specificity was determined for a GGT level greater than 197 in addition to absent or small gallbladder on USG and acholic stool in the BA group. Moreover, the presence of acholic stool (97%) exhibited the highest sensitivity and accuracy in the diagnosis of BA.Conclusion: Pale stool, GGT elevation, and absent or small gallbladder on USG are the most reliable tests for diagnosing BA. We recommend that intraoperative cholangiography should be performed without waiting for further test results when a neonate or infant presents with acholic stool, high GGT values, and absent or small gallbladder on abdominal USG

🔖

Cite This Article

AĞIN, M., TÜMGÖR, G., ALKAN, M., ÖZDEN, Ö., SATAR, M., TUNCER, R. (2016). Clues to the diagnosis of biliary atresia in neonatal cholestasis. Turkish Journal of Gastroenterology, Cilt: 27 - Sayı: 1, 37–41. https://ajindex.com/articles/409311

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (16)

  1. Ohmuna N, Takahashi H, Tanabe M, Yoshida H, Iwai J. The role of ERCP in biliary atresia. Gastrointest Endosc 1997; 45: 365-70.
  2. Hussein M, Howard ER, Mieli-Vergani G, et al. Jaundice at 14 days of age: exclude biliary atresia. Arch Dis Child 1991; 66: 1177-9.
  3. Emerick KM, Whitington PF. Neonatal liver disease. Pediatr Ann 2006; 35: 280-6.
  4. Karakayali H, Sevmis S, Ozçelik U, et al. Liver transplantation for biliary atresia. Transplant Proc 2008; 40: 231-3.
  5. Hays DM, Snyder WH Jr. Life-span in untreated biliary atresia. Sur- gery 1963; 54: 373-5.
  6. El-Guindi MA, Sira MM, Konsowa HA, El-Abd OL, Salem TA. Value of hepatic subcapsular flow by color Doppler ultrasonography in the diagnosis of biliary atresia. J Gastroenterol Hepatol 2013; 28: 867-72.
  7. Humphrey TM, Mark D. Stringer. Biliary Atresia: US Diagnosis. Radi- ology 2007; 244: 845-51.
  8. Moyer V, Freese DK, Whitington PF, et al. Guideline for the evalu- ation of cholestatic jaundice in infants: recommendations of the North American Society for Pediatric Gastroenterology, hepatol- ogy and Nutrition. J Pediatr Gastroenterol Nutr 2004; 39: 115-28.
  9. McLin VA, Balistereri WF. Approach to neoonatal cholestasis. In: Walker WA, Goulet O, Kleinman RE, Sherman PM, Shneider BL, Sanderson IR. Pediatric Gastrointestinal Disease: Pathopsychol- ogy, Diagnosis, Management. 4th ed. Ontario: BC Decker; 2004. p. 1079-93. Ohi R. Surgery for biliary atresia. Liver 2001; 21: 175-82.
  10. Poddar U, Thapa BR, Das A, et al. Neonatal cholestasis: differen- tiation of biliary atresia from neonatal hepatitis in a developing country. Acta Paediatrica 2009; 98: 1260-64.
  11. Yang JG, Ma DQ, Peng Y, et al. Comparison of different diagnostic methods for differentiating biliary atresia from idiopathic neona- tal hepatitis. Clinical Imaging 2009; 33: 439-46.
  12. Dehghani SM, Haghighat M, Imanieh MH, Geramizadeh B. Com- parison of different diagnostic methods in infants with Cholesta- sis. World J Gastroenterol 2006; 12: 5893-6.
  13. Mowat AP, Psacharopoulos HT, Williams R. Extrahepatic biliary atresia versus neonatal hepatitis. Review of 137 prospectively in- vestigated infants. Arch Dis Child 1976; 51: 763-70.
  14. Brown SC, Househam KC. Visual stool examination: a screening test for infants with prolonged neonatal cholestasis. South Afr Med J 1990; 77: 358-9.
  15. Sarı S, Egritas Ö, Barıs Z, et al. Infantile cholestatic liver diseases: ret- rospective analysis of 190 cases. Turk Arch Ped 2012; 47: 167-73.
  16. Macias MER, Keever MAV, Mucino GC et al. Improvement in accu- racy of