Featured Article| Volume 18, ISSUE 6, P622-627, June 2022

Neonatal Jaundice: Early Identification of Biliary Atresia


      • Biliary atresia is the most common indication of liver transplantation in children.
      • Biliary atresia mimics common conditions such as physiologic jaundice.
      • Biliary atresia presents with elevated levels of conjugated (direct) bilirubin.
      • Stool color cards proved to be 95.2% sensitive and showed cost-effectiveness.
      • Routine screening and early diagnosis may improve outcomes and decrease costs.


      Biliary atresia is the number one indication for liver transplantation in children. The pathophysiology involves congenital or acquired damage to the bile ducts, which causes inadequate drainage and resultant liver failure. The diagnosis of biliary atresia is frequently missed due to the lack of standardized testing and few distinctive clinical manifestations. Newborns with biliary atresia usually appear healthy at birth and subsequently develop jaundice, acholic stools, and later ascites. Early intervention with the Kasai procedure is imperative to stop liver fibrosis and prevent premature death. Most children eventually require a liver transplant despite a successful Kasai procedure.


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      Kameron Berry Price, BSN, RN, is an graduate student in the family nurse practitioner program at Clemson University, Clemson, SC. She is a perioperative nurse at AnMed Health Women's and Children's Hospital, Anderson, SC, and can be contacted at [email protected]


      Heide S. Temples, PhD, PPCNP-BC, IBCLC, is an associate professor at Clemson University, Greenville, SC, and a pediatric primary care nurse practitioner and lactation consultant in Seneca, SC.