Neonatal Cholestasis

Flowchart nodes

• Neonatal cholestis

• any baby with end 1st month of life suffering from cholestatic J. must be evaluate for Biliary atresia to do surgical intervention  before 2nd month  ///to avoid cirrhosis , ascending cholangitis

• intra-hepatic  disease

• Extra-hepatic disease

• hepatocyte injury 

• intra-hepatic bile duct disease 

• Metabolic diseases

• viral disease

• idiopathic neonatal hepatitis

• intrhepatic bile duct paucity or hypoplasia

• Extra-hepatic biliary atresia & disease

• kasai procedure is the choice

• 1-persistent acholic stool. 2-persistent bile stained fluid after duodenal intubation  against Dx.

• 1-normal  color stool with transient acholic stool 2-Duodenal intubation :-fluid is bile stained          

• 3-liver scan =sluggish uptake & fair excretion  4-liver biopsy =the most reliable discriminatory  test larged 

• 3-liver scan=good uptake BUT no excretion.  4-liver biopsy  & Exploratory laparotomy