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Biliary atresia — MRCPCH FOP MCQ

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HardGastroenterologyBiliary atresiaMRCPCH FOP

A 5-week-old girl remains jaundiced. She has pale stools, dark urine, hepatomegaly and conjugated bilirubin is elevated. What is the most appropriate management?

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Correct answer: B — Same-day referral to a paediatric liver centre

Persistent jaundice with pale stools, dark urine and conjugated hyperbilirubinaemia is cholestasis, with biliary atresia needing urgent specialist assessment. Breast milk jaundice is unconjugated and should not cause pale stools or dark urine. Phototherapy does not treat conjugated jaundice. The pearl is that stool colour is a critical question in prolonged neonatal jaundice.

Reference: NICE CG98 Jaundice in newborn babies; British Society of Paediatric Gastroenterology Hepatology and Nutrition