Neonatal Cholestasis

Imaging Studies
Ultrasound
Absent gallbladder, “triangular cord” sign
Low sensitivity; operator dependent
Evaluates for other anatomic abnormalities
Hepatobiliary scintigraphy (HIDA)
High sensitivity: normal uptake, but no excretion of
radionuclide tracer into biliary system or bowel in virtually all
patients with BA (exceptions in very early disease)
However, failure of excretion may be seen in both BA and
neonatal hepatitis
Sensitivity and Specificity increase with phenobarbital
administration
ERCP
Invasive, not readily available, technically difficult in infants
Intraoperative use is most common to confirm diagnosis and
document site of obstruction
MRCP
May become an important tool for diagnosis
Further studies are required