A 2 month baby presents with history of jaundice, turmeric colored urine and pale stools since bih. Examination reveals liver span of 10 ems. The most specific investigation for establishing the diagnosis would be -

Ans. is 'd' i.e., Liver biopsy The given clinical picture is suggestive of either of the following diagnosis: Neonatal hepatiits Extra hepatic biliary atresia "Percutaneous liver biopsy is the most valuable procedure in the evaluation of neonatal hepatobiliary disease and provides the most reliable discriminatory evidence". Biopsy findings of biliary atresia o Bile ductular proliferation o Poal or perilobular edema and fibrosis. o Bile plug o Intact basic hepatic lobular architecture. Biopsy findings of Neonatal hepatitis o Severe, diffuse hepatocellular disease o Distoion of lobular architecture. o Focal hepatocellular necrosis. o Marked infiltration with inflammatory cells. o No alteration in bile ductules. Giant cells are seen in both.