ABSTRACT
OBJECTIVES: Describe cases of children with hepatosplenomegaly (HS) attended at the General Pediatric Teaching Ambulatory (AGER) of Instituto da Criança, São Paulo, identifying the main causes, evolution, necessity for hospitalization and/or referral to specialists. METHODOLOGY: Retrospective analysis of the records of children presenting HS on admission at AGER from September 1, 1993 to August 31, 1996. RESULTS: Of the 89 children included (age range, 1 to 148 months; 24 months), 64 (72%) were referred from other services for HS investigation. Most common presenting complaints were: fever--39 (44%); pallor--26 (29%); weight loss--21 (24%) and jaundice--14 (16%). Main alterations noticed on physical examination were: pallor--47 (53%) and short stature--17 (19%). Anemia was diagnosed in 70 children (79%); 35 children (39%) had infections; 7 (8%) metabolic disorders and 5 (6%) neoplastic disorders. The most frequent infections were of the urinary tract--9 (10%) and hepatitis A--6 (7%). Thirty six children (40%) were referred to specialists, 17 of which were already diagnosed. CONCLUSIONS: Most of the children with HS present deficiency anemia associated with infections which the general pediatrician is able to diagnose. Persistence of unexplained HS for more than 2 months, especially when there is substantial volume enlargement or alteration in the organs consistency, is an indication for referral to specialists.
Subject(s)
Ambulatory Care , Hepatomegaly/etiology , Splenomegaly/etiology , Child , Child, Preschool , Female , Follow-Up Studies , Hepatomegaly/diagnosis , Hospitals, Teaching , Humans , Infant , Male , Retrospective Studies , Splenomegaly/diagnosisABSTRACT
Os autores descrevem algumas caracteristicas medico-sociais de 100 casos que procuraram o Servico de Triagem Ambulatorial do Instituto da Crianca. A renda mensal per capita da maioria das familias estudadas varia de Cr$ 4.000,00 a Cr$ 12.000,00, predominando as ocupacoes de tipo manual, especializada ou nao. Os domicilios concentram-se no proprio Municipio de Sao Paulo, sobretudo na zona oeste. A maioria dos casos foi encaminhada pelo Servico de Consultas de Urgencia e Triagem da propria Instituicao. Predominam as queixas de saude relacionadas aos aparelhos respiratorio, gastrintestinal e urinario alem de problemas comportamentais. Houve interesse dos familiares no seguimento de saude a longo prazo apos a resoluccao da quiexa basica que motivou a procura do Servico
