Neonatal Cholestasis

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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
“Triangular Cord” Sign
Page 1 and 2: Neonatal Cholestasis Jenny Bergquis
Page 3 and 4: Neonatal Cholestasis NASPGHAN Recom
Page 5 and 6: Differential Diagnosis: Hepatocellu
Page 7 and 8: Physical Exam Weight measurement
Page 9 and 10: NASPGHAN Recommendations: Imaging S
Page 11 and 12: Biliary Atresia: pathogenesis Bile
Page 13: Clinical Features History: Variabl
Page 17: Surgical Management Kasai Procedur
Page 20 and 21: If Kasai Fails? +/- support for re
Page 22 and 23: What happened to our patient? Kasa

Neonatal Cholestasis

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