Neonate with yellow eyes

A 40 days girl baby boy was brought by the mother with yellow eyes and yellow skin. Mother said that the child is irritable and not feeding well. All her vitals are WNL. Baby was born with a full-term pregnancy without any complication and weight was 3.5 Kg. Mother has 2 other healthy children born with an uncomplicated pregnancy. Mother has diabetes for last 4-5 years. Child's bilirubin concentrations was slightly increased. Rest all blood investigations are wnl except for the red cell distribution width of 15.5% (Nomal limit: 11.1%–14.3%). Physical examination was normal. Usg shows Underdeveloped bile ducts. What next step should be done?

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A case of biliary atresia. A pediatric surgical consultation is needed as child requires a surgery - KASAI 'S OPERATION- Hepato - Porto- enterostomy It will relieve - jaundice and allow the child to grow . In some patients- even after this surgery- the hepatic functions still remain compromised . For these - children- LIVER TRANSPLANTATION is the only option

Parents should have not waited so long,as per USG reports it maybe EHBA/Intrahepatic biliary atresia . Full investigations are needed/consult Ped.Hepatologist for management

Thanks dr.Ramesh kumar
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