[Analysis of delay in diagnosis of extrahepatic biliary atresia].
Prognosis of extrahepatic biliary atresia depends on an early surgical treatment. This survey studied the delay to surgery of infants treated for biliary atresia and analysed the causes of late diagnosis and referral.


METHODS
Medical files of 21 infants treated for biliary atresia between 1988 and 1998 were retrospectively analysed.


RESULTS
Median age at biliary operation was 57 days and did not change during time. In only 3/21 cases, surgery was performed before 45 days of age. The first clinical or biological sign of cholestasis was noted at a median age of 12 days. In eight cases, the first medical visit for cholestasis (median age of 21 days) was not followed by a blood test. In 11 cases, infants presenting with biological cholestasis were referred to hospital more than seven days later. False diagnosis was noted in seven cases and delayed significantly the operation.


CONCLUSIONS
The delay to surgical treatment is too long and does not decrease whereas a majority of infants visit their physician early. Medical information is mandatory for all physicians taking care of infants.
Campion
A
A
Unité de gastroentérologie, hépatologie et nutrition, clinique de pédiatrie, hôpital Jeanne-de-Flandre, 59037 Lille, France.
Guimber
D
D
Michaud
L
L
Bonnevalle
M
M
Turck
D
D
Gottrand
F
F
D001656:Biliary Atresia / Q000175:diagnosis* / Q000601:surgery*; D002779:Cholestasis / Q000209:etiology*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome