Choolestasis And Prognosis Of Jaundice

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Background and objectives: Many liver diseases are accompanied by jaundice. Differentiation of cholestatic from non-cholestatic jaundice is important. Cholestatic jaundice most probably occurs due to a pathological condition and the most frequent causes in early infancy are neonatal hepatitis and biliary atresia in early life. Early diagnosis and treatment of infantile cholestasis can improve prognosis of liver diseases by prevention of the complications of these disorders.
Patients and Methods: In this retrospective study, 122 infants under 3 months of age with cholestasis in Nemazi Hospital (affiliated to Shiraz University of Medical Sciences) during the years 2001-2011 were studied. Demographic data, duration of jaundice, liver biopsy and the causes of cholestasis were recorded.
Results: There were 76 males (62.3%) and 46females (37.7%) with a mean age of 54.4 ± 23.7 days. The most common clinical finding was Jaundice that was seen in all patients (100%) .The onset of jaundice was the first day to the fifty two days of age, with an average age of 15.6 ± 16.1 days. Other findings included hepatomegaly in 92 patients (76.4%), claycolor stool in 54 (44.3%), and splenomegaly in 29 patients (23.8%). In this study, the most common causes of cholestasis were biliary atresia (30=24.6%), idiopathic neonatal hepatitis (30= 24.6%) and bile ducts paucity (16=10.3) .
Conclusions: The results of this study showed that neonatal hepatitis and biliary atresia are the most common causes of infantile cholestasis in this area. This is a crucial warning that necessitates defining and implementing a regular system for faster diagnosis for patient management in golden time.
Keywords: Cholestasis, Biliary atresia, neonatal hepatitis.

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...most important causes of cholestasis in this region; therefore, more attention to them can help physicians to manage patients better and more effectively. In general, the results of this study are consistent with those of previous studies and it seems that the most important factor in managing patients is defining and implementing a regular system for faster diagnosis.
Finally the shortages of this study are its retrospective nature and the lack of patients’ survival reviews. Due to the sensitive nature of the disease and the need for education of GPs and pediatricians about the causes of cholestasis and its diagnosis, there is a need for more accurate studies. It is suggested that more attention should be paid to genetically determining the metabolic disorders and the facilities should be provided for diagnosis of these diseases in great centers of r medical cares.

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