Importance of Ultrasonography in Inspissated Bile Syndrome in a Neonate - A Case Report

Neonatal cholestasis is the diagnostic dilemma in clinical practice.1 It is a serious condition with the varied aetiological factors. Biliary atresia, hepatitis, choledochal cyst are common causes in neonates. Intrahepatic and extrahepatic causes can be easily differentiated by radiological investigations.2 Inspissated bile syndrome is a rare cause of neonatal jaundice.3,4 Predisposing factors for the development of inspissated bile in neonates include haemolysis, prematurity, parenteral nutrition, sepsis, and diuretic therapy.5 Ultrasonography is valuable in diagnosing the causes of obstructive jaundice especially in neonates where computed tomography scan cannot be done due to radiation exposure and MRI cannot be done due to the motion artefacts. Hepatobiliary scintigraphy single-photon emission computer tomography (HBS SPECT) is the most reliable diagnostic method. Generally, inspissated bile resolves spontaneously, but sometimes patient needs ursodeoxycholic acid. Rarely surgical drainage is also needed.Inspissated bile syndrome is a rare cause of neonatal jaundice. It is extrahepatic obstruction due to sludge of inspissated bile. We present a case of 8 days old child who presented with jaundice. Total bilirubin was raised mainly due to high levels of unconjugated bilirubin.