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Delayed Referral of a Neonate with Biliary Atresia Presenting as Jaundice: A Case Report Zubaity Ardhanariswari; Rendi Aji Prihaningtyas; Muji Retnaning Rini; Muhammad Faizi; Bagus Setyoboedi
MEDICINUS Vol. 39 No. 4 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/rmdf9491

Abstract

Delayed diagnosis of cholestasis in infant remains a significant health problem. Cholestatic jaundice is a pathological condition that requires immediate treatment, particularly in cases such as biliary atresia. Biliary atresia is a progressivefibroinflammatory process that causes fibrosis in biliary tract, resulting in liver cirrhosis if left untreated. This case report aims to describe the delayed referral of biliary atresia in an infant. Case: A 3-month-old girl presented to a tertiary hospitalwith a chief complaint of jaundice. Jaundice had been present since the second day of life and persisted despite sun exposure and breastfeeding. The mother also reported abdominal distension, yellow-brown urine resembling tea, and palestools. Physical examination revealed hepatosplenomegaly. Laboratory results showed elevated liver enzymes (aspartate aminotransferase [AST] 237.4 U/l, alanine transaminase [ALT] 139 U/l, gamma-glutamyl transferase [GGT] 864 U/l), and cholestasis (total bilirubin 13.90 mg/dl, direct bilirubin 9.80 mg/dl). A two-phase abdominal ultrasound showed a gallbladder with preprandial size approximately 0.87 x 0.93 x 1.76 cm (length x width x height), with no contractility. Liver histopathologyrevealed extrahepatic cholestasis with extensive fibrosis (F3). The patient was diagnosed with biliary atresia and liver fibrosis and was subsequently referred for liver transplantation. Delayed referral of biliary atresia case is associated withpoor prognosis. Increasing awareness and health education among primary health providers, community health workers, and parents are essential for early detection of cholestasis, which can reduce morbidity, mortality, as well as the need for liver transplantation.
Co-Authors Agrasenfani Hadi Akbas, Ahmad Maulana Ifan Amilia krisdiantini Anggi Sepfana Zizilia Anindya Kusuma Winahyu Anisa Yuniar Fadilla Annisya Dinda Paramitha Arvelina Novia Damayanti Budiono Budiono Budiono Budiono Cindy Wahyu Agustina Eighty Mardiyan K, Eighty Enny Karyani, Enny Evi Rokhayati Farahdina Farahdina Farida Triani Fathurrachman, Muhammad Rais Firyal Nadiah Rahmah Gina Noor Djalilah Gondo Mastutik Henry Wicaksono, Henry IDG Ugrasena Ilya Krisnana, Ilya Irawan, Muhammad Irwanto Irwanto Irwanto, Irwanto Jasin, Yayu Dwinita Karina Pharamita Dewi Kuntoro Kuntoro Lasmauli Situmorang Linda Dewanti Mahrus A Rahman, Mahrus A Manika Putri Kunigara Maretha Sukmawardani, Maretha Martono Tri Utomo Masturina, Melinda Maytasya Dwinaqifah Melantika Nur Fitria Syahri Melinda Masturina Muhammad Faizi Muhammad Irawan Muhammad Nur Alpi Apriansyah Muhammad Rais Fathurrachman Muji Retnaning Rini Mukarromah, Nur Nabilah Khansa Nastiti, Prima Hari Nesa, Ni Nyoman Metriani Ni Nyoman Metriani Nesa Ningrum, Astika Gita Nisak Luvi Mega Irawati Nur Mukarromah Octariyandra, Syania Mega Paramitha, Annisya Dinda Pratiwi, Fauziah Prihaningtyas, Rendi Aji Puspa Wardhani Qurrota Ayuni Novia Putri Rachmat Hargono Rahma Fadila, Zakiya Nur Rani Sidaryanti Rendi Aji Prihaningtyas Rendi Aji Prihaningtyas Reny Widayanti Samisatun Maulina, Siti Samsriyaningsih Handayani Savitri, Yovani Situmorang, Lasmauli Sjamsul Arief Sjamsul Arief Sjamsul Arief Sjamsul Arief Sjamsul Arief Sjamsul Arief, Sjamsul Sri Umijati Sulistiawati Sulistiawati Sulistiawati Sulistiawati Syahbani, Primadita Teddy Ontoseno Tiyas Kusumaningrum Tri Utomo, Martono Ulfa Kholili Utamayasa, I Ketut Alit Viky Nafi'ah Rahma Maulidia Viky Nafi'ah Rahma Maulidia Widati Fatmaningrum Winahyu, Anindya Kusuma Woro Setia Ningtyas Yovani Savitri Zizilia, Anggi Sepfana Zubaity Ardhanariswari