PROLONGED OBSTRUCTIVE JAUNDICE IN INFANCY 1. General Survey of 156 Cases

One hundred fifty-six cases of prolonged obstructive jaundice seen at the Children9s Medical Center between 1940 and 1951 have been investigated and in 85% of the patients follow-up studies have been carried out. Ninety-four (61%) were due to true biliary atresia. Twenty-three (15%) were due to inspissated bile associated with erythroblastosis. All these patients are living and well and free of jaundice. The diagnosis of this condition can be made when the patient has (1) jaundice during the first two days of life with persistence of jaundice for over three weeks, (2) a high direct and indirect bilirubin compatible with obstructive jaundice, (3) negative flocculation tests, (4) blood-grouping studies consistent with erythroblastosis. Thirty (19%) were due to inspissated bile of unknown etiology. Of these 6 are dead, 2 are alive but cirrhotic, and 18 are living and well and no follow-up was obtained on the four other cases. There appears to be some relationship between this condition and immaturity of the liver, small extrahepatic ducts, thickened secretions, and possibly dehydration. Nine (6%) were due to miscellaneous causes, of which four cases were probably due to infectious hepatitis.