A 10-day-old infant presents with persistent jaundice and dark urine that stains the diaper, along with pale, acholic (clay-colored) stools. Laboratory evaluation shows conjugated (direct) hyperbilirubinemia. What is the most likely diagnosis?
Answer and explanation
Correct answer: A. Biliary atresia
- Step 1: Direct (conjugated) hyperbilirubinemia in a neonate is never physiological and indicates cholestasis.
- Step 2: Progressive fibro-obliteration of extrahepatic biliary ducts (biliary atresia) results in acholic stools, dark urine, and liver failure.
- Step 3: Early diagnosis and surgical hepatoportoenterostomy (Kasai procedure) before 60 days of life is critical for survival.
Answer
Biliary atresia.
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