Introduction: Neonatal cholestasis is a hepatobiliay disease characterized by biliary obstruction in the neonatal period. Biochemically it is evidenced by prolonged elevation of serum conjugated bilirubin beyond the first 14 days of life.1 Most common causes are biliary atresia and idiopathic neonatal hepatitis.3, 4 Objective: To evaluate stool color as a screening test by visual inspection in infants with prolonged neonatal cholestasis. Methodology: This was a cross-sectional analytic study, conducted in Pediatric Gastroenterology and Nutrition Department,BSMMU, Dhaka, from 3 September 2012 to 3 February 2013 about 6 month duration. Statistically calculated 38 infants with prolonged neonatal direct hyperbilirubinaemia beyond their 14 days of age were included in this study. Results: The mean age of the subjects was 62.3 days with a standard deviation (SD) ±13.7 days. Male to female ratio was 1.2:1. All (100%) the subjects were icteric and hepatomegaly was found in 94.7% subjects. Dark urine (84.2%), pale stool (78.5%), bleeding manifestations (31.8%) and infection (29%) were also observed. Thirty (78.5%) subjects had pale colored stool. Mean (± SD) albumin and conjugated bilirubin levels were 3.68 (±1.88)gm/dl and 5.29 (±1.31)mg/dl respectively. ALT and GGT level of the study subjects were 346.19±124.28 u/dl and 315±198.91 u/l respectively. Common ultrasonographic findings of the patients were non visualization of gallbladder 60.5%, non-visualization of common bileduct 50%, hepatomegaly 92.1%, and triangular cord sign in portahepatis 7.9%. Scintigraphy revealed impaired excretion into intestine 88.9% in majority of the subjects. Liver biopsy revealed liver architecture was preseved 65.8% bile duct proliferation 52.6%, regenarating nodule was absent 65.8% gaint cell was present 52.6% portal tract inflammation was found in 47.4%. Sensitivity of stool color in the diagnosis of neonatal cholestasis was found 90.6%, specificity 83.3%, accuracy 89.5%, positive predictive value 96.7% and negative predictive value 62.5%. Conclusion: It can be concluded that stool color might be reliable indicator for screening of prolonged neonatal cholestasis namely biliary atresia.
展开▼
机译：介绍：新生儿胆汁淤积是一种肝毒性疾病，其特征在于新生儿时期的胆管。在生物化学的血清结合的胆红素升高超过寿命前14天的情况下证明了.1最常见的原因是胆道闭锁和特发性新生儿乙型肝炎.3，4目的：评价猪的粪便颜色作为婴儿目视检查的筛选试验长期新生儿胆汁淤积。方法论：这是在2012年9月3日至2013年2月3日达到6个月持续时间的小儿胃肠病学和努力达卡的横截面分析研究。本研究统计地计算出超过其14天的新生儿直接血红蛋白血症的38名婴儿。结果：受试者的平均年龄为62.3天，标准差（SD）±13.7天。男性与女性比例为1.2：1。所有（100％）受试者在94.7％的受试者中发现了肝脏肝肿。暗尿（84.2％），苍白粪便（78.5％），还观察到出血表现（31.8％）和感染（29％）。三十（78.5％）受试者有淡色的粪便。平均（±SD）白蛋白和共轭胆红素水平分别为3.68（±1.88）gm / dl和5.29（±1.31）mg / dl。研究受试者的Alt和GGT水平分别为346.19±124.28 U / DL和315±198.91 U / L.患者的常见超声检查结果未经胆囊的可视化60.5％，普通胆汁的非可视化50％，肝肿大92.1％，和三角形绳索签到托缺口7.9％。闪烁扫描揭示了在大多数受试者中排泄到肠道88.9％的胃部。肝脏活检显示肝脏架构预计65.8％胆管增殖52.6％，缺少65.8％的凝结细胞出现52.6％门球炎症47.4％。粪便颜色在新生儿胆汁淤积诊断中的敏感性发现90.6％，特异性83.3％，精度为89.5％，阳性预测值96.7％和负预测值62.5％。结论：可以得出结论，粪便颜色可能是可靠的指标，用于筛选延长新生儿胆碱即胆汁腹部。
展开▼
