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Parenchymatous jaundices at children of chest age - Diseases of digestive organs at children

Table of contents
Diseases of digestive organs at children
Oral cavity
Diseases of teeth
Malformations of the sky and soft tissues of an oral cavity
Diseases of a mucous membrane of an oral cavity and gums
Diseases of lips and language
Sialadens
Digestive tract
Basic reasons of gastrointestinal frustration
Gullet
Atresia and esophageal and tracheal fistula
Guttural and tracheal and esophageal crevice, inborn stenosis of a gullet
Other diseases of a gullet
Stomach and intestines
Peptic ulcer
Inborn hypertrophic pyloric stenosis
Inborn impassability of intestines
Inborn impassability of a duodenum
Disturbances of turn of intestines
Inborn impassability of a small bowel
Inborn megacolon
Diverticulums and duplikatura
The acquired impassability of intestines
Intestines invagination
Foreign bodys of a stomach and intestines
Motive frustration. stomach and intestines
Anomalies of a structure of anorectal area
Infectious diseases of intestines
Nonspecific ulcer colitis
Illness Krone
Necrotic coloenteritis of newborns
The coloenteritis connected with treatment by antibiotics
Gastrointestinal symptoms of anaphylactoid purpura, gemolitiko-uraemic syndrome
Intolerance of food proteins
Eosinophilic gastroenteritis
Absorption disturbance syndromes
Malabsorption
Immunodeficiency and intestines
Syndrome of "a congestive loop"
Syndrome of a short small bowel
Gee's disease
Sprue after acute enteritis
Tropical to a spr
Whipple's illness, intestines lymphangiectasia, Uolmap's illness, idiopathic diffusion defeat of mucous
Enzymopathies and disturbances of mechanisms of transport of nutrients
Irritable colon
Acute appendicitis
Diseases of an anus, direct and large intestine
Tumors of a digestive tract at children
Hernias of a digestive tract at children
Exocrine part of a pancreas
Pancreatitis
Embryonic development of structure and function of a liver
Diagnosis of diseases of a liver
Cholestatic states at babies
Parenchymatous jaundices at children of chest age
Disturbances of a metabolism of a liver and zhelchevydelitelny system
Anomalies of a structure of bilious ways
Cysts of bilious channels
Cholestasia and diseases of a liver connected with completely parenteral food
Medicinal damage of a liver
Ray's syndrome
Chronic hepatitis
Wilson's illness — Konovalova
Indian juvenile cirrhosis
Damages of a liver at chronic colitis
Cirrhosis and chronic liver failure
Portal hypertensia and varicosity of a gullet
Fatty infiltration of a liver
Cholecystitis
Peritoneum diseases
Peritonitis
Peritoneum hernias
IDIOPATHIC HEPATITIS OF NEWBORNS

Idiopathic defeat of a parenchyma of a liver makes 35 — 45% of all cholestatic states at children of chest age. The statistics shows that at boys it occurs twice more often than at girls, incidence is higher among premature children, family cases give the grounds to assume an autosomal and recessive mode of inheritance or existence of some environmental factor.
Clinical manifestations. The jaundice caused by hyperproduction of not conjugated bilirubin usually arises on the first week of life (80%), but can develop up to 3-month age at any time. As a rule, jaundice — the only symptom of a disease, but sometimes it is accompanied by slight anemia, a small appetite and vomiting. Dark urine and periodic decolorization a calla indicate an intra hepatic cholestasia. Almost at all patients the liver is increased, edge its equal and dense. In 50% of cases the splenomegaly is observed.
Patomorfologiya. The structure of segments is broken owing to considerable giant-cell transformation. These cells prevail in the central zones of segments. Bile accumulation by colossal cells and formation of clots of bile in tubules testifies to a heavy cholestasia in an acute stage of an illness. In every fifth case in portal zones find the cells inherent in an acute or chronic inflammation (fig. 12-25).
Datas of laboratory. Content of bilirubin in serum reaches 0,08 — 0,12 g/l, and more than 60% it are made by direct bilirubin. Level of aminotransferases increases to 400 ME, but this indicator is extremely variable. The quantity of an alkaline phosphatase is a little increased, and albumine and gamma-globulin — normal; the prothrombin time is slightly increased.
Treatment. There is no specific treatment; corticosteroids are inefficient.

Печень при гигантоклеточном гепатите
Fig. 12-25. A liver at "hepatitis of newborns" (giant-cell hepatitis). Accumulations of colossal cells in a portal zone. Inflammatory cells surround a bilious channel (shooter), a branch of a portal vein (V), a hepatic arteriole (and). Existence of a pericholangitis and fibrosis indicates forming of a chronic illness of a liver. X 100.
Forecast. By the end of the first year of life the absolute recovery comes at 75% of patients, in 25% of cases the illness passes into a chronic stage from the outcome in mikronodulyarny cirrhosis.



 
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