US approach to jaundice in infants and children

Julie A. Gubernick*, Henrietta Kotlus Rosenberg, Hakan Ilaslan, Ada Kessler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


High-resolution real-time ultrasonography (US) serves as an important tool for differentiation of obstructive and nonobstructive causes of jaundice in infants and children, independent of liver function. Unconjugated hyperbilirubinemia occurs in approximately 60% of normal term infants and in 80% of preterm infants. Persistence of neonatal jaundice beyond 2 weeks of age demands US evaluation to differentiate between the three most common causes: hepatitis, biliary atresia, and choledochal cyst. In all three conditions, the hepatic echotexture is diffusely coarse and hyperechoic, but this appearance may be seen in a variety of hepatic inflammatory, obstructive, and metabolic processes. Thus, hepatic scintigraphy and at times percutaneous liver biopsy are necessary to narrow the differential diagnosis and to identify patients who require more invasive techniques (eg, intraoperative cholangiography). US is useful for demonstrating inspissated bile and biliary duct stones. In infants, stones are usually secondary to obstructive congenital anomalies of the biliary tract, total parenteral nutrition, furosemide treatment, phototherapy, dehydration, infection, hemolytic anemia, and short-gut syndrome, whereas in older children, stones are usually associated with sickle cell disease, bowel resection, hemolytic anemia, and choledochal cyst. Jaundice in infants and children may also be due to cirrhosis, benign strictures, and neoplastic processes.

Original languageEnglish
Pages (from-to)173-195
Number of pages23
Issue number1
StatePublished - 2000
Externally publishedYes


  • Bile ducts, abnormalities, 76.288
  • Bile ducts, cysts, 766.1492
  • Children, gastrointestinal tract
  • Hepatitis, 761.291
  • Infants, gastrointestinal tract
  • Jaundice, 76.288, 761.291, 766.1492
  • Liver, diseases, 76.28, 761.291


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