Betamethasone in plus phenobarbitone prior to hepatobiliary scintigraphy increases diagnostic accuracy in infants with jaundice

Abstract

Addition of BM increases the diagnostic accuracy of the HBS and this would lead to decreased need for POC to distinguish NH from EHBA.

Three-Dimensional Magnetic Resonance Cholangiopancreatography for the Diagnosis of Biliary Atresia in Infants and Neonates

“…Hepatobiliary scintigraphy can reliably exclude the diagnosis of BA by indicating the drainage of radiotracer into the small bowel. The sensitivity of scintigraphy for the diagnosis of BA was demonstrated to be 83–100%, whereas the specificity was relatively lower, ranging from 70–80% [19], [20]. In rare cases, bile drainage is initially present in infants with cholestatic disease but is subsequently lost after two to three weeks of age.…”

Neonatal cholestasis: differentiation of biliary atresia from neonatal hepatitis in a developing country

“…The negative laparotomy rate with this approach (laparotomy for scan negative children) is in the tune of 40% (6). Efforts have been made to improve the accuracy of HBS by adding phenobarbitone, phenobarbitone plus dexamethasone and duodenal intubation (9,12,13). However, the accuracy of HBS still falls short of a satisfactory level.…”

Clinical Course of Obstructive Jaundice Associated with Operated Meconium Peritonitis in Neonates

“…Other risk factors for cholestasis are short bowel syndrome, sepsis, shock, transfusion, and postoperative complications such as intestinal perforation and bowel obstruction [3] . In the present study, all patients underwent TPN and 4 of the 11 cases had postoperative complications (Cases 2, 6,7,9). In most cases, the favorable therapeutic policy for prolonged jaundice after laparotomy for meconium peritonitis is conservative treatment including a wait-and-see approach, medical treatment, and exchange blood transfusion if needed.…”

“…Second, steroids inhibit the infl ammatory response to the hepatocyte, and could decrease edema, collagen deposition and also arrest the migration of infl ammatory cells. Thirdly, steroids also decrease the hemoglobin load presented to the liver through stabilization of the RBC membrane with a resultant decrease in cell breakdown [2,7] . Generally, the greatest concern in infantile cholestasis is the presence of biliary atresia.…”