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Neonatal Cholestasis Urgency — RACP Paediatrics MCQ

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ModerateGastroenterologyNeonatal Cholestasis UrgencyRACP Paediatrics

A newborn has persistent conjugated jaundice at 3 weeks with pale stools. The next critical step in the diagnostic workup is determining whether this is biliary atresia. What is the urgency?

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Correct answer: D — Investigation should be completed and Kasai performed before 60 days of age for optimal outcomes

Conjugated jaundice with pale stools at any age requires urgent investigation. The key differential is biliary atresia, where Kasai portoenterostomy must be performed ideally before 30 days and certainly before 60 days of age. Delayed diagnosis is the main determinant of poor outcomes.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Neonatal Cholestasis