Abstract | BACKGROUND: Once it is established that a jaundiced infant has an elevated direct bilirubin level, the principal diagnostic concern is the differentiation of hepatocellular from obstructive cholestasis, of disorders of physiology from disorders of anatomy, and of disease that is managed medically from disease that is managed surgically. Traditional tests such as ultrasonography, liver biopsy, and technotium 99m HIDA scan are often not sufficiently discriminating. General anesthesia is required for invasive imaging with endoscopic retrograde cholangio pancreatography (ERCP) or operative cholangiogram. The authors describe a facile alternative using percutaneous cholecystocholangiography (PCC) with intravenous sedation. METHODS: Nine cholestatic infants underwent PCC (age, 27 to 73 days; mean, 44 days) after ultrasoundscan, liver biopsy, and ( 99mTc)HIDA scan failed to provide a definitive diagnosis. RESULTS: CONCLUSIONS: When the etiology of cholestasis remains elusive after traditional firstline tests, PCC has proven to be an accurate simple alternative in differentiating obstructive from hepatocellular causes of infantile cholestatic jaundice.
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Authors | Rebecka L Meyers, Linda S Book, Molly A O'Gorman, Keith W White, Richard B Jaffe, Peter G Feola, Gary L Hedlund |
Journal | Journal of pediatric surgery
(J Pediatr Surg)
Vol. 39
Issue 1
Pg. 16-8
(Jan 2004)
ISSN: 1531-5037 [Electronic] United States |
PMID | 14694364
(Publication Type: Journal Article)
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Topics |
- Biliary Atresia
(complications, diagnostic imaging)
- Cholangiography
(methods)
- Cholecystography
(methods)
- Humans
- Hyperbilirubinemia
(etiology)
- Infant
- Infant, Newborn
- Jaundice, Obstructive
(complications, diagnostic imaging)
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