Differentiation of biliary atresia and neonatal hepatitis with radionuclide hepatobiliary scintigraphy

Differentiation of infantile jaundice is a critical and difficult problem. This paper retrospectively evaluated the use of hepatobiliary scintigraphy in 23 consecutive infants with neonatal cholestasis. The direct serum bilirubin concentration was 71.82∼545.49 μmol/L. During the first study, only six of the 23 patients had gastrointestinal excretion of the tracer. In 17 patients without excretion, a second study was done after oral administration of phenobarbital 5 mg · kg-1·d-1 for 7 to 10 days. The gastrointestinal excretion of radionuclide was shown in 2 of the 17 patients. Final diagnosis of this group was: 15 cases with biliary atresia and 8 neonatal hepatitis, including 2 cases whose gastrointestinal excretion was noted on the second study