Pediatric Medicine

Answer 5 Biliary atresia. The finding of conjugated hyperbilirubinemia in the first month of life, especially in a patient with acholic stools and a firm liver, should immediately prompt consideration of biliary atresia. Viral hepatitis does occur in newborns but generally presents with additional symptoms including poor feeding, vomiting, and irritability. Physiologic jaundice and ABO incompatibility generally occur in the first days of life and are characterized by an increase in unconjugated bilirubin. Breast milk jaundice does appear after the first week of life and can persist for several weeks but is also characterized by an increase in unconjugated bilirubin. SUGGESTED READING Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia: Saunders; 2004. Click here to return to the questions

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