Abstract
Objectives: This study was undertaken to know about the magnitude, clinical spectrum and etiology of liver diseases in children in a tertiary care teaching hospital. Materials and Methods: This is a hospital based, retrospective, descriptive study. It was done on 45 children with hepatobiliary diseases admitted to pediatric department of Velammal Medical College, Madurai from Jan 2016 – Dec 2016. Results: As about 45 children out of 2259 pediatric admissions, had hepatobiliary disorders. This was contributing to 1.99% of total admissions. Liver function test was deranged in (73.3%) of children. Males (62.2%), outnumbered, females (37.7%) in our study. Children less than 5 years of age were most commonly affected (46.6%). Most common symptom in children with hepatobiliary disorders were jaundice (51.1%), nausea/vomiting (46.6%), anorexia (40%), pain abdomen (33.3%), high coloured urine (28.8%), bleeding manifestations and abdomen distension in (20%) each, fever in (17.7%), failure to thrive and irritability in (15.5%) each. The most common sign observed was icterus (51.1%), hepatomegaly (42.2%). Ascitis and splenomegaly was noted in (26.6%) each, edema in (20%) and pallor in (15.5%) of children. Acute liver diseases were more common (68.8%) than chronic liver diseases (31.1%). The most common etiology of acute liver disease was acute viral hepatitis (28.8%), cholelithiasis (22.2%), non-alcoholic fatty liver disease (6.6%), liver abscess (4.4%), acute viral hepatitis with acalculous cholecystitis in (4.4%), acute liver failure due to paracetamol poisoning in (2.2%) of children. Etiology noted for chronic liver diseases were biliary atresia (13.3%), idiopathic cirrhosis and wilsons disease in (6.6%) each, autoimmune hepatitis and chronic hepatitis in (2.2%) each. Conclusion: Since age is the single most important determinant in successful management of biliary atresia, recognition and definitive identification of the condition as the cause of neonatal cholestasis syndrome in a given case very early after the onset of symptoms is of paramount importance.
Highlights
Childhood liver disorders constitute a major proportion of hospital admissions in India
Liver diseases among children include a broad spectrum of disorders such as infections, developmental abnormalities and metabolic disorders that result in hepatic dysfunction and cirrhosis
Hepatobiliary disorders was most commonly seen in children less than 5 years of age 21 (46%), followed by, children of 11-15 years of age 15 (33.3%) and 6-10 years of age 9 (20%)
Summary
Childhood liver disorders constitute a major proportion of hospital admissions in India. Manuscript received: 18th April 2017 Reviewed: 26th April May 2017 Author Corrected: 6th May 2017 Accepted for Publication: 15th May 2017 significantly to childhood morbidity and mortality. The clinical features of liver dysfunction may include symptoms related to digestion problems such as abnormal fat absorption and metabolism, coagulopathies, blood sugar abnormalities and immune disorders. Others include features of cholestasis, portal hypertension and esophageal varices [2]. Liver diseases among children include a broad spectrum of disorders such as infections, developmental abnormalities and metabolic disorders that result in hepatic dysfunction and cirrhosis. Acute and chronic liver diseases constitute the majority of liver disorders among
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