Duodenal intubation and aspiration test: utility in the differential diagnosis of infantile cholestasis.
A prospective study involving 27 infants with cholestatic jaundice was carried out to evaluate the diagnostic utility of the 24-h duodenal drainage test. Extrahepatic cholestasis was confirmed by either exploratory laparotomy or autopsy in 12 of 13 cases without bile drainage, with only one false-positive result. The sensitivity of this test for extrahepatic cholestasis was 100% while the accuracy and specificity were 96.3 and 93.3%, respectively. The corresponding sensitivity, accuracy, and specificity for liver biopsy in patients with extrahepatic cholestasis were 83.3, 92.6, and 100%, respectively. It is concluded that the duodenal drainage test is a simple, rapid, and inexpensive procedure with high sensitivity and specificity in the diagnosis of infantile cholestasis.