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Neonatal Cholestasis, Pediatric

Irini D. Batsis, MD and Wikrom Karnsakul, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Neonatal cholestasis is defined as elevated conjugated bilirubin levels that occur in the newborn period and often extends during the infancy. It typically indicates hepatobiliary dy...

DIAGNOSIS

HISTORY

  • Pregnancy and birth history

  • History of consanguinity

  • Family history/racial background

  • Infectious exposure

  • TPN exposure, prolonged history of NPO status

  • Presence/absence of extrahepatic man...

TREATMENT

MEDICATION

  • Ursodeoxycholic acid (improvement in hepatic function and absorption of fat-soluble vitamins)

  • Cholic or chenodeoxycholic acid for BASD

  • Antihistamines (for pruritus associated with ch...

ONGOING CARE

DIET

  • Nutritional support needed. Typically, an elemental formula with high content medium-chain triglycerides is better absorbed in cholestasis.

  • Consider need for nasogastric tube feeds.

  • Spe...

ADDITIONAL READING

  • Bakshi B, Sutcliffe A, Akindolie M, et al. How reliably can paediatric professionals identify pale stool from cholestatic newborns? Arch Dis Child Fetal Neonatal Ed.  2012;97(5...

CODES

ICD9

  • 576.8 Other specified disorders of biliary tract

  • 751.61 Biliary atresia

  • 774.4 Perinatal jaundice due to hepatocellular damage

  • 273.4 Alpha-1-antitrypsin deficiency

ICD10

  • K83.1 Obstruction of bile ...

FAQ

  • Q: What information in the patient’s history can be used to identify neonatal cholestasis?

  • A: Direct observation of urine color along with stool color, as acholic stools and dark urine suggest the ...

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