Stool Color Card Screening for Early Detection of Biliary Atresia

Abstract

Purpose: The aim of this study was to determine the usefulness of the Stool Color Card (SCC) for the early detection of biliary atresia (BA) and the prevention of vitamin K deficiency hemorrhage (VKDH).

Method: A retrospective chart review was conducted on 41 patients who underwent Kasai enterostomy (KPE) at our hospital from 2005 to 2018. We compared the ages at admission and KPE, and the incidence of VKDH between the early group of 27 patients before (2005–2011) and the late group of 14 patients after (2012–2018) the implementation of SCC screening. We also compared the ages at admission and KPE between 13 patients with VKDH and 28 patients without VKDH. A survey on the use of SCC by pediatricians in Hyogo Prefecture was performed.

Results: There were no significant differences between the early and late groups in terms of the ages at admission [64 (8–102) vs. 62 (0–86) days] and KPE [70 (22–111) vs. 69.5 (25–97) days], nor the incidence of VKDH (29.6% vs. 35.7%). The ages at admission and KPE were significantly later in patients with VKDH than in those without VKDH [66 (43–86) vs. 52 (0–86) days, p = 0.03; 74 (59–97) vs. 59.5 (22–111) days, p = 0.01].

87% of the survey participants considered that SCC was useful for the early detection of BA; however, 86% answered that they needed more information about SCC.

Conclusions: The usefulness of SCC for the early detection of BA might be limited, unless parents, as well as health care providers, are more informed about SCC.