Abstract

Aim: To evaluate the different tools in the diagnosis of neonatal cholestasis, to determine the causes of its late diagnosis and to underline the importance of early recognation and management in patients especially with extrahepatic biliary atresia. Methods: In t his study we evaluated the infants with neonatal cholestasis admitted to our hospital between January and December 2004 based on their histories and clinical, laboratory, radiologic and histopathologic characteristics. Results: The median age was 9 days at the onset of the jaundice and was 106 days when they were hospitalized. 55.6% of the cases had biliary atresia, 33.3% idiopathic neonatal hepatitis and 11.1% Eyler disease. The causes of the late diagnosis were acceptance of these patients as physiological jaundice of newborns by their parents and doctors, and not performing any further examinaton. We found that laboratory, ultrasonography and hepatobiliary sintigraphy investigations were inadequate for diagnosis, and the liver histology appeared to be the most valuable diagnostic method for the precise diagnosis. Conclusioms Since the early diagnosis is important, to examine the stool colour in newborns with prolonged jaundice beyond two weeks of life may be a good screening test for neonatal cholestasis. When acholic or pale stool is evident, fractioned serum bilirubin levels should be always investigated with performing further investigations.