Obstructive jaundice in a child: usual presentation of an unusual tumor

Abstract

A 3-year-old boy presented with painless jaundice of 3 days' duration. Physical examination was significant for jaundice and hepatomegaly. Laboratory data were remarkable for alanine aminotransferase (ALT) of 649 IU/L (normal, 10-41 IU/L), aspartate aminotransferase (AST) of 559 IU/L (normal, 0-34 IU/L), alkaline phosphatase of 1626 IU/L (normal, 100-499 IU/L), total bilirubin of 10.9 mg/dL (normal, 0.3-1.2 mg/dL), and direct bilirubin of 5.9 mg/dL (normal, 0-0.2 mg/dL). A lipid panel was remarkable for low-density lipoprotein (LDL) cholesterol of 717 mg/dL (normal, 0-130 mg/dL).