Early detection of biliary atresia is important for optimum patient management. An elevation of serum direct (conjugated) bilirubin can be the first clue of the diagnosis.
Screening for serum direct bilirubin can be performed:
(1) in a newborn
(2) at first well-child visit
Indications for monitoring serum direct (conjugated) bilirubin:
(1) elevated serum direct bilirubin concentration (above upper limit of normal) on a neonatal screen. Elevated serum direct biliurbin concentrations are seen in neonates 24-48 hours old with biliary atresia.
(2) rising trend in serum direct bilirubin concentration
(3) pale stools
(4) unexplained jaundice
The ratio of direct bilirubin to total bilirubin may not be elevated in neonates with biliary atresia.
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