Prolonged conjugated hyperbilirubinaemia--evaluation using duodenal fluid inspection for bile.

Fatimah Yakin, FRCR Departments of Paediatrics and Radiology Fakulti Perubatan Universiti Kebangsaan Malaysia P. O. Box 2418 Kuala Lumpur However, the 131 I-Rose Bengal faecal excretion test is not only expensive and time-consuming but is often inaccurate because of difficulty in stool collection. The percutaneous liver biopsy is also not without error 4 and consent from parents are not always forthcoming. Some centres have used abdominal scanning for qualitative evidence of isotopic excretion but this is less accurate. 5 Prior to the introduction of our approach in the General Hospital, Kuala Lumpur, evaluation of conjugated hyperbilirubinaemia in infancy involved operative cholangiography and open liver biopsy. This approach will inevitably result in laparotomy of cases with neonatal hepatitis. Duodenal fluid inspection has been adopted in Japan 6.7 and a few centres in USA including South America and has been found to be quite reliable.