ABSTRACT
ABSTRACT Objectives: Liver biopsy is the gold standard for assessing liver inflammation, necrosis and fibrosis. The aim of the study is to evaluate clinical indications and histopathological results of percutaneus liver biopsy. Materials and methods: A total of 516 children who underwent blind liver biopsy were evaluated retrospectively. Results: Blind liver biopsy was performed for chronic active hepatitis B in 50% of the cases (n=260), neonatal cholestasis in 14% (n=68), autoimmune hepatitis in 7.7% (n=40), Wilson disease in 7.3% (n=38), isolated elevation of the liver enzymes in 5% (n=26), chronic active hepatitis C in 4.2% (n=22), metabolic disease in 3.4% (n=17), malignancies in 2.2% (n=11) and the others in 3.4% (n=17). Major complications were observed in 0.19% of the cases (n=1) and minor complications such as pain at the biopsy site in 13.5% of the cases (n=70), hypotension and tachycardia in 1.9% (n=10). Conclusions: Blind liver biopsy is a safe method in diagnosing liver diseases in childhood.
RESUMEN Objetivos: La biopsia de hígado es el estándar de oro para evaluar la inflamación, necrosis y fibrosis del hígado. El objetivo del estudio es evaluar las indicaciones clínicas y los resultados histopatológicos de la biopsia hepática percutánea. Materiales y métodos: Se evaluó retrospectivamente a un total de 516 niños a los que se les realizó una biopsia hepática a ciegas. Resultados: Se realizó biopsia hepática a ciegas por hepatitis B crónica activa en el 50% de los casos (n = 260), colestasis neonatal en el 14% (n = 68), hepatitis autoinmune en el 7,7% (n = 40), enfermedad de Wilson en el 7,3%. % (n = 38), elevación aislada de las enzimas hepáticas en el 5% (n = 26), hepatitis C crónica activa en el 4,2% (n = 22), enfermedad metabólica en el 3,4% (n = 17), neoplasias en el 2,2% (n = 11) y los demás en un 3,4% (n = 17). Se observaron complicaciones mayores en el 0,19% de los casos (n = 1) y complicaciones menores como dolor en el sitio de la biopsia en el 13,5% de los casos (n = 70), hipotensión y taquicardia en el 1,9% (n = 10). Conclusiones: La biopsia hepática a ciegas es un método seguro en el diagnóstico de enfermedades hepáticas en la infancia.
Subject(s)
Child , Humans , Infant, Newborn , Hepatitis C, Chronic , Liver Cirrhosis , Biopsy , Retrospective Studies , Liver/pathology , Liver Cirrhosis/pathologyABSTRACT
Objective. Evaluation of children younger than two years old admitted to a pediatric emergency department with upper gastrointestinal bleeding. Methods. Thirty four (34) children aged < 2 years with upper gastrointestinal bleeding were studied. The demographic features, etiologies, laboratory and endoscopic findings and treatment procedures were evaluated retrospectively. Results. The study consisted of 34 patients (73.5 % male, 26.5 % female) with a median age 12.3 months (1.5–24 months). 30 patients (88 %) had an underlying disease. 21 patients (56 %) had a history of aspirin or nonsteroidal anti-inflammatory drugs intake. Endoscopic findings were pathological in 85% of patients. Conclusion. The incidence of upper gastrointestinal bleeding in children aged < 2 years due to antipyretics must be taken into consideration although most of them may also have an underlying disease.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Aspirin/administration & dosage , Endoscopy, Gastrointestinal , Gastrointestinal Hemorrhage/diagnosis , Female , Gastrointestinal Hemorrhage/etiology , Humans , Infant , Infant, Newborn , Male , Retrospective Studies , Risk FactorsABSTRACT
We report two immunocompromised infants aged six and four months with invasive gastrointestinal aspergillosis. Both patients presented with weight loss and diarrhea. The underlying disorders were combined immunodeficiency and transient hypogammaglobulinemia of infancy. The diagnosis of gastrointestinal aspergillosis was established by gastrointestinal endoscopy and histopathological examination of the tissue specimens. Both children responded well to Amphotericin B.