NEGATIVE
LIVER BIOPSY
IF SIGNS OF
BILIARY
OBSTRUCTION
Cholestasis
and / or
cholestatic jaundice
Abdominal
ultrasound :
dilatation of
bile ducts?
Persistently
pale or
acholic
stool
YES
Biliary lithiasis
Choledochal cysts
Other extrahepatic causes
Biliary atresia
Neonatal sclerosing cholangitis
Exclude or assess:
Check for :
liver biopsy recommended but
not always feasible depending
on center
Check for :
Alagille syndrome
Alpha-1-antitrypsin deficiency
Cystic fibrosis
Cortisol deficiency
YES
NO
CHOLANGIO-
GRAM
NEGATIVE
LIVER BIOPSY
IF SIGNS
OF
BILIARY
OBSTRUCTION
Cholestasis
and / or
cholestatic jaundice
Abdominal
ultrasound :
dilatation of
bile ducts?
Persistently
pale or
acholic
stool
YES
Biliary lithiasis
Choledochal cysts
Other extrahepatic causes
Biliary atresia
Neonatal sclerosing cholangitis
Exclude or assess:
Check for :
Check for :
Alagille syndrome
Alpha-1-antitrypsin deficiency
Cystic fibrosis
Cortisol deficiency
YES
NO
CHOLANGIO-
GRAM
liver biopsy recommended
but not always feasible
depending on center
1. Adapted from, Protocole national de diagnostic et de soins : Déficits de synthèse des acides biliaires primaires. In: Génétiques CdRCdlAdVBedC, ed., 2019.
Under conjonction and advices of experts in paediatric gastroenterologisy and hepatology
CTRS-INSTIT-PLATEDUC-ONG03/20/07/20
