Let’s talk about jaundice/icterus today. It translates the presence of excess bilirubin in the human body. Bilirubin is mainly produced in the process of red blood cell destruction (hemolysis) and is metabolized in the liver before elimination from the human body. However in some people, due to varied conditions, there could be accumulation of this pigment before/after arrival at the liver or within the liver. This should lead to URGENT medical assessment to appreciate the severity and extent of the situation.

If you meet someone with yellow eyes (that is the white part of the eyes are looking yellowish), don’t LAUGH or IGNORE but rather encourage them to do a check-up in a standard/REFERENCE healthcare structure if they haven’t done so.

Today we present 3 cases of neonates/infants with jaundice.

NB: Jaundice should be evaluated urgently NOT JUST in infants.

#Case 1:
A male infant aged 6 weeks 5 days brought by mum for a large abdomen and yellow skin coloration. The infant was born at term from a moderately followed-up pregnancy. No anomalies at birth and post-delivery period was without complications. Mum noticed mildly yellow eyes in the baby at about 3 weeks of life for which baby was placed in the sun as commonly practiced and advised in her entourage. The coloration seemed to persist and intensify in the eyes, becoming associated to a distended abdomen leading to consultation in nearby unnamed clinic at about 5 weeks of life. A number of drugs were administered over days with very little change. To these, added fever for which infant was given Paracetamol injections with temporary relief. The persistence of symptoms and generalized yellow coloration of the infant’s skin led to this consultation.
On clinical exam, ill-looking infant, very yellow with fever, and tachypnea. Icteric Sclerae, Distended abdomen with visible collateral veins, difficult palpation, splenomegaly, dullness, bowel sounds heard.
Diagnosis was late bacterial Neonatal infection in portal hypertension on biliary atresia. Bilirubin levels revealed elevated total and conjugated bilirubin. Abdominal ultrasound confirmed diagnosis indicating cirrhotic liver.

Prognosis was analysed by surgeons as poor. Broad spectrum antibiotics were initiated prior to surgery.
Infant died few days later before surgery.🙁

See Next Post for end of write-up.
#gastroenterology #surgery #neonatology #subsaharanafrica #medicine #health #pediatric #childhealth #mum #parent