Child health · UKMLA & AKT
Biliary atresia
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Prolonged jaundice - persisting beyond 14 days (term) or 21 days (preterm); always conjugated (direct) hyperbilirubinaemia
- Pale/acholic stools - chalky white or putty-coloured due to absent bile pigment
- Dark urine - conjugated bilirubin is water-soluble and spills into urine
- Hepatomegaly - firm, enlarged liver due to cholestasis and early fibrosis
- Splenomegaly - develops as portal hypertension progresses
- Poor weight gain/failure to thrive - fat malabsorption due to absent bile delivery
Pale stools + dark urine in a jaundiced neonate = biliary atresia until proven otherwise. Any conjugated hyperbilirubinaemia at any age requires urgent investigation.
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