Can Stereological Studies Be Helpful in Differentiating Biliary Atresia from Neonatal Hepatitis?

Cholestatic jaundice is a potentially dangerous condition which is often misdiagnosed by paediatricians as physiological or breast milk jaundice. The two most common causes of neonatal cholestasis (NC) are biliary atresia (BA) and neonatal hepatitis (NH). Early and accurate differentiation of these two entities is very important as early surgery in BA improves the biliary drainage but the delay leads to irreversible hepatocellular damage. There has been much discussion over the value of hepatobiliary radioisotopic scans, liver histopathological features, serum g-glutamyl transpeptidase (GGTP) levels, and other tests which are widely used for differentiation of BA from NH. Stereology provides practical techniques for extracting quantitative information about a threedimensional material from measurements made on two-dimensional planar sections of the tissues. We suggest that the stereological study of different components of liver tissue may be useful in determining the function of liver and differentiating some liver diseases such as biliary atresia and neonatal hepatitis.