In the evaluation of jaundice in infancy, the differentiation between neonatal hepatitis and biliary atresia may be difficult since there is considerable overlap in the clinical features and the liver biopsy findings. Visualization of the biliary system is desirable and may be diagnostic. This has been accomplished in most cases by operative cholangiography. We report preoperative confirmation of the diagnosis of extrahepatic biliary atresia by endoscopic retrograde cholangiopancreatography (ERCP) in a 4-month-old infant.
Report of a Case.—A 3-week-old female infant, the product of an uncomplicated pregnancy and full-term delivery, was noted to be jaundiced. Laboratory values at five weeks included the following: total serum bilirubin, 9.8 mg/dL; direct bilirubin, 2.5 mg/dL; SGOT, 70 IU/L; and SGPT, 50 IU/L. A liver biopsy performed at ten weeks was interpreted as showing "chronic active hepatitis" and the child was treated with corticosteroids.
One month later, the infant was taken to New York