Discussion :
This child was detected to have clay coloured stools right from birth though jaundice was not picked up. Isolated clay coloured stools without jaundice is rare. The colour of the stools is due to the presence of bile in the stools and thus absence of bile will lead to decolonization of stool. Since the infant is predominantly on milk diet in the 1st few months of life, the colour of stool is white unless bile is present. Absence of bile can occur due to liver disease or obstruction of bile flow. Thus, when there is presence of clay coloured stools, one should always look for jaundice. Neonatal cholestasis is a condition that should be picked up as early in life as possible because delay can lead to irreversible liver damage as seen in this patient. Thus, when one comes to across a child with clay coloured stools, always look at the liver and check for jaundice.
E-published: September 2009, Vol 6 Issue 9 Art No. 50
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