Neonatal Cholestasis Syndrome: an experience at army medical college and Military Hospital Rawalpindi

Abstract

Objective: To find the causes of neonatal cholestasis in our set up and to see the role of liver biopsy in differentiating neonatal hepatitis from biliary atresia. Design: A cross sectional survey. Place and duration of study: Histopathology department of Army Medical College and Military Hospital Rawalpindi from January 2000 to December 2004. Patients and Methods: A total of 62 cases were studied with age range of 1.5 months to 5 years. The subjects selected for biopsy were children with persistent jaundice and hepatosplenomegaly. The biopsy was taken with the help of Surecut needle under the cover of diluted intravenous Ketamine. The fixed tissues were processed under standard conditions. Result: Majority of the patients (62.90%) were of biliary atresia followed by neonatal hepatitis (27.42%). Paucity of bile ductules was seen in 3 cases while three patients were of indeterminate etiology. Cirrhosis of liver was noted in 10 patients; six because of biliary atresia and two cases each of alpha-1 antitrypsin deficiency and galactosemia. Amongst neonatal hepatitis cases most of the patients were idiopathic in nature (58.82%). Conclusion: In our set up, biliary atresia is an important and main cause of neonatal cholestasis and liver biopsy is a valuable diagnostic tool in differentiating biliary atresia from neonatal hepatitis.