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Cholestasia and diseases of a liver connected with completely parenteral food - 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
CHOLESTASIA AND DISEASES OF THE LIVER CONNECTED WITH THE COMPLETELY PARENTERAL FOOD (CPF)

Liver dysfunction — the most frequent metabolic complication of parenteral food. At 80% of the patients receiving this type of treatment the level of serumal aminotransferases is increased; at chest age jaundice, and most often (40 — 50%) At newborns develops. It is necessary to distinguish benign reversible dysfunction of a liver owing to PPP and explicit, potentially irreversible illness of a liver which amplifies against PPP. Factors which contribute to development of dysfunction of a liver or its destruction in the patients receiving PPP are listed in tab. 12-16. The major factors defining development of a cholestasia in the children receiving PPP are prematurity, duration of treatment and character of a basic disease. At PPP proceeding more than 2 weeks, the probability of a cholestasia is very high, but after transition to usual food normal department of bile is recovered. Origins PPP-zavisimogo of a cholestasia are not found out; it is possible to assume that it is connected with disturbance of products or biliary secretion under the influence of some amino acids, insufficiency of essential fatty acids, disturbance of transport of feedstuffs through membranes of hepatic cells.

Table 12-16. Complications from a liver at PPP


Liver dysfunction

The contributing factors

| Main manifestations

Prematurity Long PPP Imbalance of nutrients Excess of amino acids Deficit of amino acids
Surplus of calories

Cholestasia
Cholestasia
Cholestasia
Fatty hepatosis (kwasiorkor)
Fatty hepatosis

Liver diseases

The contributing factors

 Main manifestations

System infections Gastrointestinal frustration Necrotic coloenteritis Colitis
Abdominal surgical interventions intestines Atresia Doubling of a stomach Gepatotoksichny substances

Cholangitis
Cholangitis and fibrosis

Cholangitis and fibrosis - the Necrosis and fibrosis

Unlike functional frustration the true illness of a liver develops seldom, but can be serious, life-threatening complication. To development of inflammatory or fibroziruyushchy process in a liver of children, it is long the receiving PPP, sepsis, surgical interventions on abdominal organs and a necrotic coloenteritis can promote. When against these diseases and PPP there is jaundice, it is necessary to make a transdermal biopsy of a liver. If in bioptata find periportal inflammatory process, the centers of a necrosis and fibrosis, then transition to an enteroalimentation is shown by special mixes. Such mixes of nutrients are well transferred at introduction to a stomach kapelno through a nasal probe; in certain cases such feeding is supplemented with intravenous injections of glucose.
The hepatomegalia and slight increase of level of aminotransferases in the absence of a cholestasia can appear if the caloric content of PPP exceeds 100 kcal/(kg-days). In these cases increase in a liver is caused by adjournment of fat in it. At reduction of caloric content of food fatty stocks are utilized. The ratio between amount of carbohydrates and proteins can play a certain role in development of a fatty hepatosis, however the optimum ratio, apparently, is defined by a basic disease p a condition of food of the patient prior to the beginning of PPP.
At the children who were above chest age, hepatic complications of PPP arise less often and proceed easier. However disturbances of functions of a liver are frequent at children who within months, and even flying receive houses excessively caloric food. Are especially subject to complications from a liver children with intestines diseases against which infectious process or dysbacteriosis develops. At most of such patients the level of aminotransferases decreases upon partial transition to enteral feeding. However if the maintenance of an alkaline phosphatase and gamma glyutamiltransferazy is at the same time increased, then it is possible to suspect more serious damage of a liver; in such cases it is necessary to carry out a biopsy.



 
"Diseases of bodies of an urinary system at children   Diseases of the lacrimal bodies"