Obstructive Jaundice in Early Infancy

Abstract

The aetiology of obstructive jaundice, as encountered in 113 Black and 17 White infants, as well as the clinical manifestations and prognosis, are discussed, together with a review of the literature. The commonest causes in Black infants were syphilitic hepatitis (28 patients), neonatal hepatitis (27), elltlahepiltic biliary atresia (20), venoocclusive disease (8) and sepsis (6). Of the 17 White infants 12 suffered from neonatal hepatitis, 4 from the 'inspissated bile syndrome' following blood group incompatibility, while only 1 had extrahepatic biliary atresia. The clinical features of these entities as well as the difficulty of distinguishing between neonatal hepatitis and biliary atresia are discussed. The importance of establishing the cause of obstructive jaundice as soon as possible is stressed, because specific treatment is available In the case of some of the entitles, especially syphilis, sepsis alld ordinary Infection. Obstructive jaundice in infancy is a serious disorder. Fifty-two of the 113 Black infants died while stili in hospital or soon after discharge, and It was obvious that at least another 20 would die of cirrhosis at a later stage, the expected mortality, therefore, being at least 64%.

S. Afr. Med. J., 48, 811 (1974).