A 2 month baby presents with history of jaundice, turmeric colored urine and pale stools since bih. Examination reveals liver span of 10 cms, firm in consistency and spleen of 3 cms. The most specific investigation for establishing the diagnosis would be:
All patients suspected of having biliary atresia should undergo exploratory laprotomy and direct cholangiography to determine the presence and site of obstruction. Ref: Kliegman, Behrman, Jenson, Stanton (2008), Chapter 353, "Cholestasis", In the book, "NELSON TEXTBOOK OF PEDIATRICS", Volume 2, 18th Edition, New Delhi, Page 1673; Harrison's Internal Medicine, 18th Edition, Page 2624.
Liver function tests
Ultrasound abdomen
Peroperative cholangiogram
Liver biopsy