Conjugated Hyperbilirubinemia in Children

Education Gaps Awareness of telltale signs and performance of appropriate diagnostic testing can help clinicians identify neonatal cholestasis in time to ameliorate its potentially catastrophic outcomes. The success of the Kasai procedure to restore bile flow is directly related to patient age: at less than 60 days after birth, two-thirds of patients benefit from the procedure; however, at 90 days after birth, chances for bile drainage diminish markedly. Objectives After completing this article, readers should be able to: Understand the metabolism of bilirubin, the differences between conjugated and unconjugated bilirubin, and the relationship of conjugated hyperbilirubinemia to cholestasis. Delineate the causes of cholestasis in the newborn and know how to evaluate the cholestatic neonate. Manage the infant who has prolonged cholestasis. Understand the causes of conjugated hyperbilirubinemia in the older child and adolescent and know how to assess children who have conjugated hyperbilirubinemia.