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Biliary atresia — RACP Paediatrics MCQ

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ModerateGIBiliary atresiaRACP Paediatrics

A 6-week-old presents with persistent jaundice, pale acholic stools, dark urine, and hepatomegaly. Conjugated bilirubin is 120 µmol/L. GGT is markedly elevated. Ultrasound shows absence of the gallbladder and a triangular cord sign at the porta hepatis. What is the most likely diagnosis?

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Correct answer: B — Biliary atresia

Biliary atresia is the most common surgically treatable cause of neonatal cholestasis. Pale stools, dark urine, conjugated hyperbilirubinaemia, elevated GGT, absent gallbladder, and a triangular cord sign on ultrasound are characteristic. Kasai portoenterostomy should be performed before 60 days of age for optimal outcomes.

Reference: RCH Melbourne – 2023 – Neonatal Cholestasis CPG; RACP Paediatric Curriculum – GI