Question
A premature baby weighing 1950g at 35 weeks of gestation is now 42 days old. Ten days ago, they were hospitalized due to jaundice, with a direct bilirubin level of 4140μmol/L. After 10 days of treatment, the direct bilirubin level decreased to 40.9μmol/L, and the indirect bilirubin level decreased to 35μmol/L. The doctor suspects bile duct obstruction and suggests an abdominal laparoscopy. Is the decrease in bilirubin levels indicative of bile duct obstruction?
Answer
An elevated direct bilirubin level may suggest abnormal bilirubin metabolism, particularly in areas of poor excretion in the liver. Administration of gamma globulin can help boost the child’s immunity, while traditional Chinese medicine is often used as a liver protective agent. Considering that the child may have an incomplete bile duct obstruction, there is a possibility of spontaneous resolution as they grow older. However, boosting the child’s immunity may cause it to exceed normal levels. It is worth noting that if there is indeed bile duct obstruction, the direct bilirubin level usually does not decrease. However, auxiliary examination results are for reference only and may not be entirely accurate, and it is recommended to recheck the bilirubin levels.