ABSTRACT
A 56-day-old male infant is admitted to the pediatric ward for work-up of jaundice. The child was born by spontaneous vaginal delivery at term, to healthy young parents of Mediterranean descent. He has been breastfed since birth and has gained weight well with no illnesses during the first two months of life. At the two-month check-up, his pediatrician noted the child to be jaundiced. On further questioning, the parents noted that his stools had become progressively pale in color, and that his urine had become darker over the previous 2–3 weeks. The child was referred to the hospital for direct admission after blood tests showed a total bilirubin level of 196.1 μmol/L (11.5 mg/dL), a direct bilirubin of 118.5 μmol/L (6.9 mg/dL) and a gamma glutamyl transferase (GGT) of 626 units/L. Electrolytes and complete blood count are normal. On admission, the pediatric team consults gastroenterology and pediatric surgery.
