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Needle Biopsy of the Liver:  An Aid in the Differential Diagnosis of Prolonged Jaundice in Infancy

ROBERT KAYE, M.D.; C. EVERETT KOOP, M.D.; BERNARD M. WAGNER, M.D.; DAVID PICOU, M.B.; WILLIAM C. YAKOVAC, M.D.
AMA Am J Dis Child. 1959;98(6):699-709. doi:10.1001/archpedi.1959.02070020701005.
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The differential diagnosis of infants with prolonged obstructive jaundice is usually puzzling and often in error.1 The differentiation between obstruction to the outflow of bile on the basis of hepatocellular disease and that due to atresia of the extrahepatic bile ducts is made difficult by a variety of factors. Among these are the frequency with which hepatitis leads to prolonged, essentially complete obstruction to the outflow of bile into the intestinal tract,2,3 the poor correlation between the results of the commonly used tests for hepatic parenchymal cell damage (flocculation, turbidity1 and transaminase tests5), and the disease process affecting the patient. The unreliability of histories concerning the time of onset of jaundice and the character of stool color,1 as well as the results of chemical tests for bile pigments in urine and stool, may also lead to error in diagnosis.1,4

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