ABSTRACT
A case of hepatocellular carcinoma complicating biliary cirrhosis caused by biliary atresia is reported. The patient had persistent severe jaundice with hepatosplenomegaly. A liver tumor was suspected because of the elevated serum alpha-fetoprotein and was shown by ultrasonography at 6 years of age. The tumor was treated with percutaneous ethanol injection therapy (PEIT). Nine months after initiation of PEIT, the patient died of massive bleeding from a metastatic tumor.
Subject(s)
Biliary Atresia/complications , Carcinoma, Hepatocellular/etiology , Liver Cirrhosis/etiology , Liver Neoplasms/etiology , Biliary Atresia/pathology , Biomarkers, Tumor/analysis , Carcinoma, Hepatocellular/pathology , Child, Preschool , Fatal Outcome , Female , Humans , Liver/pathology , Liver Cirrhosis/pathology , Liver Function Tests , Liver Neoplasms/pathology , Palliative Care , alpha-Fetoproteins/analysisABSTRACT
We investigated the long-term results and ongoing management issues of 39 Japanese children who underwent liver transplantation in Brisbane, Australia. Whole liver grafts were used in 15 patients (Wh group) and reduced-size grafts were used in 24 patients (Re group). The 1-year and 3-year survival rates were 74% and 60%, respectively, and all cases of late mortality which occurred after 6 months were due to infection. Statistical analysis showed no differences between the Wh and Re groups with regard to late mortality or liver function tests, although 4 of 24 (16.7%) patients from the Re group developed a recurrence of esophageal varices. Three patients treated with cyclosporine developed lymphoproliferative disorders following transplantation, but none of the patients developed severe nephrotoxicity or hypertension. Although a "catch-up" gain in weight was observed, poor growth in height was displayed, and there were no differences between the Wh and Re groups in this regard. Thus, we conclude that late complications of liver transplantation in children are common and further studies are necessary to evaluate the ongoing growth problems.
Subject(s)
Biliary Atresia/surgery , Liver Transplantation/methods , Postoperative Complications/therapy , Australia , Biliary Atresia/mortality , Body Height/physiology , Body Weight/physiology , Cadaver , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Infant , Japan/ethnology , Liver Function Tests , Male , Organ Size/physiology , Postoperative Complications/mortality , Survival RateABSTRACT
A newborn having a covered anus and two fistulas, one ano-urethral and one penile urethro-cutaneous, is presented. In spite of the resemblance of this ano-urethral fistula to an "H-type" ano-urethral fistula, which is thought to result from the failure of the division of the cloaca in the embryological period, three abnormalities seen in this case were thought to be the result of a serial event which occurred in the more distal part, the anal and the genital folds, during the embryological period.
Subject(s)
Anus, Imperforate/complications , Fistula/complications , Penis , Skin , Urethra , Anus, Imperforate/surgery , Fistula/diagnostic imaging , Humans , Infant, Newborn , Male , Penis/diagnostic imaging , Radiography , Urethra/diagnostic imagingABSTRACT
An umbilical core-out operation for a completely patent vitelline duct in a premature baby with successful preoperative manual reduction of the prolapsed ileal loops is described. In certain cases with this rare anomaly this procedure can be applied. The procedure is easy, timesaving, bloodless and necessitates no laparotomy incision.
