Differential Diagnosis of Extrahepatic Biliary Atresia from Neonatal Hepatitis

Lai, Ming-Wei; Chang, Mei–Hwei; Hsu, S. T.; Hsu, Hey‐Chi; Su, Cheng-Tau; Kao, Chuan-Liang; Lee, Chin‐Yun

doi:10.1097/00005176-199402000-00001

Cited by 108 publications

(103 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study found that liver needle biopsy was the most reliable method with the highest accuracy rate of 96.9%, which is similar to those in previous reports [2,12,15] .…”

Section: Discussionsupporting

confidence: 92%

Comparison of different diagnostic methods in infants with Cholestasis

Dehghani

Haghighat²,

Imanieh³

et al. 2006

WJG

View full text Add to dashboard Cite

“…Our study found that liver needle biopsy was the most reliable method with the highest accuracy rate of 96.9%, which is similar to those in previous reports [2,12,15] .…”

Section: Discussionsupporting

confidence: 92%

Comparison of different diagnostic methods in infants with Cholestasis

Dehghani

Haghighat²,

Imanieh³

et al. 2006

WJG

View full text Add to dashboard Cite

“…BA was correctly diagnosed histologically in 30 of 33 cases while non-BA was correctly diagnosed in 33 of 35 cases. This degree of diagnostic accuracy is in keeping with observations made by other authors [3,11,18] , but is lower than the degree of diagnostic accuracy reported by Lai et al [4] . Moyer et al [12] reported that with percutaneous liver biopsy, the sensitivity for BA was 89%-99% and specificity was 82.5%-98%.…”

Section: Discussionsupporting

confidence: 90%

“…Liver biopsy is one of the most important diagnostic steps in the evaluation of NC and may be performed safely even in the smallest infants with local anaesthesia and sedation [3,4] . Percutaneous liver biopsy has been found to be particularly helpful in infants suspected of having BA in developing countries [5] .…”

Section: Introductionmentioning

confidence: 99%

Usefulness of a scoring system in the interpretation ofhistology in neonatal cholestasis

Lee¹,

Looi²

2009

WJG

View full text Add to dashboard Cite

AIM:To ascertain the usefulness of a histological scoring system devised to assist in the interpretation of liver histology in neonatal cholestasis (NC). METHODS:Liver biopsy specimens obtained from infants with NC referred to a tertiary pediatric unit in Malaysia were prospectively studied. The first author, blinded to the final diagnosis, devised the histological diagnosis based on a 7-feature (portal ductal proliferation, bile plugs in portal ductules, portoportal bridging, lymphocytic infiltration in portal region, multinucleated hepatocytes, neutrophilic infiltration, hepatocellular swelling), 15-point (0 to 15) scoring system. The author classified the histological diagnosis as either biliary atresia (BA) or neonatal hepatitis (NH, all other diagnoses), and subsequently compared the author's diagnosis with the final diagnosis. RESULTS:Eighty-four biopsy specimens obtained from 78 patients were reviewed. Without the scoring system, BA was correctly diagnosed by the author histologically in 30 cases, labelled as NH in 3. For other diagnoses, BA was excluded correctly in 33 cases and mislabeled as BA in 2 cases. The overall sensitivity for BA was 91%, specificity 86% and accuracy 88%. With the scoring system, a score of ≥ 7 had the best diagnostic utility to differentiate BA from other intrahepatic cholestasis histologically (sensitivity 88%, specificity 94%, accuracy 92%). Four patients with a score < 7 had BA, and 3 patients with a score ≥ 7 had NH. CONCLUSION:A 7-feature, 15-point histological scoring system had good diagnostic accuracy in the interpretation of liver histology in neonatal cholestasis.

show abstract

“…[15][16][17][18][19][20][21] The last two studies were performed in Brazil. This study was compared with the other two Brazilian studies in view of the institutional similarities.…”

Section: Discussionmentioning

confidence: 99%

Acurácia diagnóstica do espessamento ecogênico periportal à ultra-sonografia e da histopatologia no diagnóstico diferencial da atresia biliar

Roquete¹,

Ferreira²,

Fagundes³

et al. 2008

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objectives: To define the sensitivity, specificity and accuracy of the ultrasound triangular cord sign and hepatic histopathology, in isolation or in combination, for diagnostic differentiation between biliary atresia and intrahepatic cholestasis. Methods:This was a retrospective study carried out between January 1990 and December 2004. Fifty-one cases of biliary atresia and 45 of intrahepatic cholestasis were analyzed. Histopathology was performed blind by a pathologist.The triangular cord sign was identified in ultrasound reports as the only diagnostic sign of biliary atresia. Sensitivity, specificity and accuracy were calculated for the triangular cord sign and histology both in isolation and in combination.The gold standard for diagnosis of biliary atresia was the appearance of the extrahepatic biliary tree via laparotomy. Results:The triangular cord sign alone had sensitivity of 49%, specificity of 100% and accuracy of 72.5%.Histopathology compatible with extrahepatic biliary obstruction alone had 90.2% sensitivity, 84.6% specificity and 87.8% accuracy. The triangular cord sign and histopathology in isolation or combination resulted in sensitivity of 93.2%, specificity of 85.7% and accuracy of 90.3%. Conclusions:Finding the triangular cord sign on ultrasound is an indication for laparotomy. If the triangular cord sign is negative, liver biopsy is indicated; if histopathology reveals signs of biliary atresia, explorative laparotomy is indicated. In cases where the triangular cord sign is absent and histopathology indicates neonatal hepatitis or other intrahepatic cholestasis, clinical treatment or observation are recommended in accordance with the diagnosis.J Pediatr (Rio J). 2008;84(4):331-336: Neonatal cholestasis, biliary atresia, ultrasound, liver biopsy.

show abstract

Differential Diagnosis of Extrahepatic Biliary Atresia from Neonatal Hepatitis

Cited by 108 publications

References 0 publications

Comparison of different diagnostic methods in infants with Cholestasis

Comparison of different diagnostic methods in infants with Cholestasis

Usefulness of a scoring system in the interpretation ofhistology in neonatal cholestasis

Acurácia diagnóstica do espessamento ecogênico periportal à ultra-sonografia e da histopatologia no diagnóstico diferencial da atresia biliar

Contact Info

Product

Resources

About