1 Department of Pediatrics
2 Department of Surgery
3 Department of Radiology, Arkansas Children's Hospital, Little Rock, AR 72201
Majd et al (Pediatrics 67: 140, 1981) refer to hepatobiliary scintigraphy with 99m-labeled p-isopropylacetanilido iminodiacetic acid (99mTc-PIPIDA) as a highly accurate test for differentiating biliary atresia from other causes of neonatal jaundice. We agree that this technique is superior to rose bengal. However, their conclusion that it is highly accurate may be premature in view of the limited number of patients. Indeed the test is very sensitive (100%), but prior to their innovative use of phenobarbital it was not very specific (58%).