Accuracy of Pale Stools, Splenomegaly, Hepatomegaly, Gamma Glutamyl Transferase, and Alkaline Phosphatase for Diagnosis of Biliary Atresia

Introduction: Biliary atresia (BA) is a condition of progressive sclerosis in the extrahepatic biliary tract which if left untreated, can lead to cirrhosis and liver failure. The diagnosis of BA must be done promptly because it is associated with a better prognosis if treatment is done earlier. We aimed to determine the accuracy of clinical features (hepatomegaly, splenomegaly, and pale stools), and laboratory findings (gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP)) for diagnosis of BA. Methods: We analyzed the medical records of BA patients and cholestatic non-BA patients as controls who were admitted to our hospital from 2009 to 2017. Results: We ascertained 34 BA patients and 39 cholestatic non-BA subjects. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of clinical features (combination of hepatomegaly, splenomegaly, and pale stools) and laboratory findings (combination of GGT and ALP) were 62.5, 48.6, 51.3, and 60, and 93.3, 22.2, 50, and 80, respectively; while the Sn, Sp, PPV, and NPV for combination of clinical and laboratory findings were 58.6, 62.9, 56.7, and 64.7. Conclusion: A combination of clinical features and laboratory findings show a moderate accuracy for the diagnosis of BA. These findings imply that BA diagnosis might be early established using very simple and routine examination; therefore, suspicious BA patients can be referred to the pediatric surgical center for diagnosis establishment and treatment can be performed earlier accordingly. Our study provides a comprehensive analysis of clinical and laboratory findings as potential early detection tools for BA. © 2024 Elsevier B.V., All rights reserved.