Question of the Week

Question :
Posted On : 26 Nov 2023
A 6-month female infant born to G2 with a history of previous spontaneous abortion to an nc married couple presented with a history of jaundice, clay-colored stools(intermittently) since 2nd week of life (now 5mths 15 days), no e, o neurological impairment, developmentally normal, presently playful, serially investigated to find bilirubin always more than 6 m percent (direct More than 5 mg percent), recently admitted with tsb=16 mg percent (pre dominantly conjugated) for evaluation, prothrombin time on several occasions abnormal (inr More than 2), on regular treatment with inj. vit k, sr. proteins now within normal range, sgot, sgpt raised, alk. phosphatase raised up to 806 iu, urine for reducing sugars being negative. Advice on further steps and management.
Expert Answer :
Since the child has clay stools and neonatal cholestasis with direct hyperbilirubinemia, the child should be evaluated for biliary atresia. A TORCH titre, GGTP, and urine for reducing substances should be done. HIDA and USG abdomen to look for obstruction. A liver biopsy will help to determine if there is biliary atresia.
Answer Discussion :
lusungu muchelenganga
TORCH screen
Abdominal imaging +intraoperative cholangiogram.
Liver biopsy
G6P levels
Sickle cell test +Hb electrophoresis

6 months ago
khaled abuahmed
Abdominal US. TORCH screen?


6 months ago
padamati govardhan
Best is liver biopsy to confirm biliary atresia,alpha 1 anti trypsin deficiency,
6 months ago
rasha almahi
Liver biopsy with intraoperative cholangiogram
6 months ago
inma amoros
Abdominal ultrasound
6 months ago

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