Usefulness of ultrasonography and biochemical features in the diagnosis of cholestatic jaundice in infants
العنوان: | Usefulness of ultrasonography and biochemical features in the diagnosis of cholestatic jaundice in infants |
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المؤلفون: | Michelo S Choopa, Samuel O. M. Manda, Celeste Kock, Alta J. Terblanche, Dankwart Friedrich Wittenberg |
المصدر: | South African Journal of Child Health. 10:75 |
بيانات النشر: | South African Medical Association NPC, 2016. |
سنة النشر: | 2016 |
مصطلحات موضوعية: | medicine.medical_specialty, medicine.diagnostic_test, biology, business.industry, Aspartate transaminase, Hepatology, medicine.disease, Gastroenterology, Neonatal hepatitis, 03 medical and health sciences, 0302 clinical medicine, Cholestasis, Biliary atresia, 030225 pediatrics, 030220 oncology & carcinogenesis, Abdominal ultrasonography, Internal medicine, Pediatrics, Perinatology and Child Health, biology.protein, Medicine, Medical diagnosis, Ultrasonography, business |
الوصف: | Background. Biliary atresia is a common cause of cholestasis. In our experience, patients with biliary atresia are referred late, with the diagnosis based on an absent gall bladder at ultrasonography. Such late referrals may render patients inoperable and not acceptable for formal intraoperative diagnosis. Objectives. To determine the usefulness of an absent gall bladder on ultrasonography, and of biochemical features, in differentiating biliary atresia from other causes of cholestasis, using liver needle biopsy as a gold standard. Methods. A retrospective file review of 150 infants presenting with cholestasis to Steve Biko Academic Hospital Paediatric Gastroenterology and Hepatology Unit from January 2008 to August 2014 was undertaken. Clinical, serum biochemical, abdominal ultrasonography and liver histology findings were analysed. Three groups were compared, based on liver histology findings, consisting of patients with biliary atresia, neonatal hepatitis, and other diagnoses, respectively. Results. A total of 66/150 patients had biliary atresia, based on liver histology findings of extrahepatic obstruction. Their mean age was 4.7 (2.9) months, higher than in the other groups. In those with biliary atresia, the age at diagnosis, splenomegaly, and gamma glutamyl transferase (GGT), aspartate transaminase (AST) and GGT/AST ratio values were significantly different from the other groups. Total and conjugated bilirubin levels were similar among the groups. Ultrasonography was 69.7% sensitive, 98.8% specific and had a positive predictive value of 97.9% for biliary atresia. Ultrasonography missed 30.3% of patients with biliary atresia. Conclusion. Ultrasonography has poor sensitivity but good specificity in screening for biliary atresia; however, other investigations are necessary to confirm the diagnosis. |
تدمد: | 1999-7671 1994-3032 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::83a348b8a9472c6382a9e0d43d2e42ed https://doi.org/10.7196/sajch.2016.v10i1.1075 |
حقوق: | OPEN |
رقم الأكسشن: | edsair.doi...........83a348b8a9472c6382a9e0d43d2e42ed |
قاعدة البيانات: | OpenAIRE |
تدمد: | 19997671 19943032 |
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