Operational Diagnostic Criteria in Conjunction with the Triangular Cord Sign Enhance the Screening for Biliary Atresia

Authors

  • Md Jahidur Rahman Lecturer, Department of Forensic Medicine & Toxicology, Sir Salimullah Medical College, Dhaka, Bangladesh.
  • Manash Talukdar Talukdar Assistant Registrar, Department of Paediatric Surgery, MAG Osmani Medical College Hospital, Sylhet.
  • Md Mahbub Hossain Assistant Professor, Department of Radiology & Imaging, National Institute of Ophthalmology and Hospital, Dhaka.
  • Shabnam Rashedi Assistant Professor, Department of Paediatric Surgery, Sylhet MAG Osmani Medical College.
  • Sabrina Rahman Mahi Intern, Community Based Medical College, Bangladesh, Mymensingh.

DOI:

https://doi.org/10.3329/jpsb.v14i1.88457

Keywords:

Biliary atresia, Diagnostic accuracy, Infantile cholestasis, Operational criteria, Screening, Triangular cord sign, Ultrasonography

Abstract

Background: Background: The early and accurate diagnosis of biliary atresia (BA) is critical for timely intervention. The triangularcordsign (TCS) onultrasonographyisavaluabletool, butitsdiagnosticperformancecanbevariable. Objective: To evaluate whether the use of operational diagnostic criteria (ODC) in conjunction with TCS enhances the screening accuracy for BA. Methods: A prospective cohort studz was conducted at MAGOsmani Medical College Hospital, Szlhetin Bangladesh from July 2021 to December 2022. A total of 60 infants with persistent jaundice underwent evaluation for biliary atresia via triangular cord sign, operational diagnostic criteria, and confirmation by intraoperative cholangiography. Data were analyzed with SPSS 23.0. Results: Among 60infants, biliary atresia was confirmed in 38 (63.3%).The triangularcord sign (TCS) showed 76.3% sensitivity and 86.4% specificity. Operational diagnostic criteria (ODC) alone demonstrated 89.5% sensitivity. Crucially, combining TCS and ODC (positive ifeither was positive) significantly enhancedsensitivity to97.4%(p<0.001) with aspecificity of 77.3%. Then egativepredictivevalueforthecombinedmodel was 94.4%, and its AUC of 0.94 was superior to either tool alone. Conclusion: The combination of operational diagnostic criteria with the triangular cord sign creates a highly sensitive and effective screening algorithm for biliary atresia. This integrated approach outperforms either method in isolation and can significantly enhance early detection, timely referral, and ultimately, improve outcomes for infants with this serious condition.

Journal of Paediatric Surgeons of Bangladesh (2023) Vol. 14 (1 & 2): 31-35

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Published

2026-04-08

How to Cite

Rahman, M. J., Talukdar, M. T., Hossain, M. M., Rashedi, S., & Mahi, S. R. (2026). Operational Diagnostic Criteria in Conjunction with the Triangular Cord Sign Enhance the Screening for Biliary Atresia. Journal of Paediatric Surgeons of Bangladesh, 14(1), 31–35. https://doi.org/10.3329/jpsb.v14i1.88457

Issue

Vol. 14 No.1-2 (2023)

Section

Original Articles

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