Objectives: To clinch the diagnosis of complex neonatal liver diseases (where all other diagnostic modalities fail) this study was conducted in a Tertiary Care Centre of Northern India.

Materials and Methods: The neonates who attended pediatric Gastroenterology Clinic of PGIMER – Chandigarh from July 2000 to June 2003 having history of liver disease (i.e. Jaundice , clay colored stool, high colored urine, hepatosplenomegaloy, syndromic features, sibling history of liver disease etc) were subjected to liver biopsy when history, clinical examination, USG abdomen, LFT, HIDA Scan, per operative cholangiogram, enzyme study  of metabolic disease) fail to establish diagnosis. Liver biopsy was done as per standard protocol considering all safety measures.

Result: Out of total 50 neonates (who had liver  biopsy), 15 (30%) had biliary atresia (bile duct proliferation, bile plugs , portal fibrosis, normal lobular architecture), 30 (60%) had ideopathic neonatal hepatitis (multi nucleated giant cells, pseudoglandular transformation, dilated canaliculi, inflammatory  infiltrates in heaptocellular lobules with necrosis, mild portal tract fibrosis, bile duct proliferation), One (2%) had galactosemia (diffuse hepatocellural damage, marked steatosis, cholestasis, pseudoacinar transformation), one (2%) had alfa one antitrypsin deficiency (PAS positive Diastase resistant alfa one  antitrypsin inclusion in peripheral hepatocytes, bile stasis, minimal inflammation), one (2%) had non syndromic paucity of intrahepatic bile ducts  having low ratio of <.9 of intra lobular ducts to portal tracts).

Conclusion: Neonatal liver biopsy is an important investigation for making accurate diagnosis of complex liver disease

Keywords: neonatal liver biopsy, complex liver disease.

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Sujay Chaudhuri

Division of Pediatric Gastroenterology, Department of Gastroenterology, PGIMER Chandigarh

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