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Choledochal cyst nutrition

Ching-Chung Tsai, Po-Kai Huang, Hsien-Kuan Liu, Yu-Tsun Su, Ming-Chun Yang, Ming-Lun Yeh
RATIONALE: Choledochal cysts are a congenital disorder of the common bile duct that can cause progressive biliary obstruction and biliary cirrhosis. They were classified by Todani into five types. Of these, type VI choledochal cysts are rarely reported in the literature. PATIENT CONCERNS: A 22-month-old girl presented with intermittent epigastralgia for approximately 10 days and fever for three days. Fasting and total parenteral nutrition were administered after admission...
October 2017: Medicine (Baltimore)
Su Jeong Lee, Jung Eun Kim, Byung-Ho Choe, An Na Seo, Han-Ik Bae, Su-Kyeong Hwang
PURPOSE: The goal of this study was the early diagnosis of ABCB11 spectrum liver disorders, especially those focused on benign recurrent intrahepatic cholestasis and progressive familial intrahepatic cholestasis. METHODS: Fifty patients presenting neonatal cholestasis were evaluated to identify underlying etiologies. Genetic analysis was performed on patients suspected to have syndromic diseases or ABCB11 spectrum liver disorders. Two families with proven ABCB11 spectrum liver disorders were subjected to genetic analyses to confirm the diagnosis and were provided genetic counseling...
June 2017: Pediatric Gastroenterology, Hepatology & Nutrition
A Sánchez Galán, A Vilanova Sánchez, L Martínez Martínez, M Dore Reyes, M Romo Muñoz, V Núñez Cerezo, F Hernández Oliveros, M López Santamaría
AIM: In patients with a choledochal cyst, the malformation and subsequent biliodigestive reconstruction lead to a non-physiological state in the digestive tract and biliary excretion that could affect the child's growth. The effect of this malformation and its surgical treatment are reviewed here in a large patient cohort. MATERIAL AND METHODS: Retrospective review of patients undergoing surgery for choledochal cyst in the last 20 years. Nutrition and liver function parameters, weight and height data were collected from medical records...
July 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Ji Chen, Bin Jiang, Jun Yi, Lei Huang, Xinmin Si
PURPOSE: To report our experience with a modified biliary-enteric anastomosis procedure for the surgical treatment of congenital choledochal cysts. METHODS: Between January 2009 and December 2013, 91 children (19 boys, 72 girls; ages, 6-145 months) with congenital choledochal cysts were treated with our modified surgical procedure in our hospital. Of these patients, 69 had type I cysts, and 22 had type IV B cysts. The main parameters analyzed mainly included the operative time, duration of bowel recovery, resumption of diet, postoperative hospital stay, liver-function tests, postoperative complications, and prognosis...
June 2017: Pediatric Surgery International
Zafar Fayyaz, Huma Arshad Cheema, Hassan Suleman, Muhammad Almas Hashmi, Arit Parkash, Nadia Waheed
BACKGROUND: Childhood Pancreatitis is an uncommon but serious condition with incidence on the rise. It manifests as acute or chronic form with epigastric pain, vomiting and elevated serum -amylase and lipase. This study was conducted with the aim to determine the clinical presentation, aetiology, and complications of pancreatitis in children. METHODS: This descriptive case series was conducted in the Department of Paediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital & the Institute of Child Health, Lahore from 1st January to 31st December 2014...
July 2015: Journal of Ayub Medical College, Abbottabad: JAMC
Ajay Verma, Veereshwar Bhatnagar, Shyam Prakash, Abhay Kumar Srivastava
AIM: Our study aims to find various enzymatic and biochemical components of bile and their clinical or prognostic correlation with regard to progression and severity of hepatobiliary diseases. MATERIALS AND METHODS: It was a cross-sectional study where all the patients suffering from choledochal cyst (CDC), extrahepatic portal venous obstruction (EHPVO), and infantile obstructive cholangiopathy undergoing diagnostic preoperative cholangiogram; and patients with history of total parenteral nutrition (TPN) undergoing surgery for some other condition were included in the study...
July 2014: Journal of Indian Association of Pediatric Surgeons
Neha Kwatra, Eglal Shalaby-Rana, Srikala Narayanan, Parvathi Mohan, Sunil Ghelani, Massoud Majd
BACKGROUND: Hepatobiliary scintigraphy is highly sensitive for diagnosing biliary atresia; however, its specificity has varied in the literature from 35% to 97%. OBJECTIVE: The purpose of this study was to re-evaluate the accuracy of phenobarbital-enhanced hepatobiliary scintigraphy in differentiating biliary atresia from other causes of neonatal cholestasis. MATERIALS AND METHODS: We retrospectively reviewed all hepatobiliary scans of infants with cholestasis at our institution from December 1990 to May 2011...
October 2013: Pediatric Radiology
Matthew T Santore, Katherine J Deans, Brittany J Behar, Thane A Blinman, N Scott Adzick, Alan W Flake
BACKGROUND: Laparoscopic surgical techniques have been applied for reconstruction after choledochal cyst resection. The aim of our study was to report the technical details of laparoscopic hepaticoduodenostomy and to compare outcomes between the open and laparoscopic approaches at our institution. METHODS: We performed a retrospective analysis of children with choledochal cyst who underwent hepaticoduodenostomy between August 2005 and May 2009. Patients were divided into open and laparoscopic groups based on the surgical approach...
May 2011: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Chun-Chieh Huang, Ming-Shian Tsai, Hong-Shiee Lai
We report a case of chylous ascites developing 2 weeks after excision of a choledochal cyst with a Roux-en-Y hepaticojejunostomy. Despite the failure of the initial attempts to resolve the chylous ascites by fasting, subsequently, we successfully treated the patient's chylous ascites with intravenous somatostatin. No obvious adverse side effects occurred during the use of somatostatin. To the best of our knowledge, this is the first report of chylous ascites after choledochal cyst excision in children, which was successfully treated with somatostatin...
May 2009: Journal of Pediatric Surgery
Julia Serber, Enno Stranzinger, James D Geiger, Daniel H Teitelbaum
Two infants are described who presented in the neonatal period with a direct hyperbilirubinemia. This was initially presumed to be because of the diagnosis of gastroschisis and the prolonged use of parenteral nutrition. However, both infants were eventually found to have an associated choledochal cyst. The cases are a novel association not previously reported and should heighten the awareness that anatomical causes of a direct hyperbilirubinemia need to be ruled out in all neonates.
March 2009: Journal of Pediatric Surgery
Nuthapong Ukarapol, Lumduan Wongsawasdi, Siriwan Ong-Chai, Pornthawee Riddhiputra, Prachya Kongtawelert
BACKGROUND: The purpose of the present paper was to evaluate the value of biochemical markers, including conventional liver function tests, gamma-glutamyl transferase (GGT), and hyaluronic acid (HA), in the diagnosis of neonatal cholestasis. METHODS: Infants with neonatal jaundice were consecutively enrolled during 1 year period. The patients were diagnosed as having biliary atresia (BA) if there was either bile ductular proliferation in the portal tracts, atretic common bile duct/gallbladder, or evidence of bile duct obstruction demonstrated by liver pathology or intraoperative cholangiography, respectively...
October 2007: Pediatrics International: Official Journal of the Japan Pediatric Society
Prapun Aanpreung, Mongkol Laohapansang, Ravit Ruangtrakool, Jongkolrat Kimhan
The objective of this study was to study etiologies and outcome of neonatal cholestasis in Thai infants. The medical records of infants aged less than 3 months with the diagnosis of neonatal cholestasis in Department of Pediatrics, Siriraj Hospital from 1993 to 2004 were retrospectively reviewed. The etiologies were diagnosed by history, physical examination, and proper investigations. There were 252 infants, including 135 males (53.6%) and 117 females (46.4%). The etiologies of cholestasis were idiopathic neonatal hepatitis (INH) 23%, extrahepatic biliary atresia (EHBA) 22...
November 2005: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Cara L Mack, Rebecca M Tucker, Ronald J Sokol, Frederick M Karrer, Brian L Kotzin, Peter F Whitington, Stephen D Miller
A proposed mechanism in the pathogenesis of biliary atresia involves an initial virus-induced, progressive T cell-mediated inflammatory obliteration of bile ducts. The aim of this study was to characterize the inflammatory environment present within the liver of infants with biliary atresia to gain insight into the role of a primary immune-mediated process versus a nonspecific secondary response to biliary obstruction. Frozen liver tissue obtained from patients with biliary atresia, neonatal giant cell hepatitis, total parenteral nutrition (TPN)-related cholestasis, choledochal cysts, and normal control subjects was used for fluorescent immunohistochemistry studies of cellular infiltrates, cytokine mRNA expression, and in situ hybridization for localization of cytokine-producing cells...
July 2004: Pediatric Research
Ellen Kahn
Extrahepatic biliary atresia (EHBA) is an inflammatory fibrosing process affecting the extrahepatic and intrahepatic biliary tree resulting in fibrous obliteration of the extrahepatic biliary tract, ductopenia of intrahepatic bile ducts, and biliary cirrhosis. EHBA is divided into a correctable and a noncorrectable type with focal patency of the otherwise atretic biliary tree in the former and no patency of the biliary tree in the noncorrectable type. EHBA is divided in a fetal, prenatal or embryonic, and a more common, perinatal, acquired form...
March 2004: Pediatric and Developmental Pathology
J A Gubernick, H K Rosenberg, H Ilaslan, A Kessler
High-resolution real-time ultrasonography (US) serves as an important tool for differentiation of obstructive and nonobstructive causes of jaundice in infants and children, independent of liver function. Unconjugated hyperbilirubinemia occurs in approximately 60% of normal term infants and in 80% of preterm infants. Persistence of neonatal jaundice beyond 2 weeks of age demands US evaluation to differentiate between the three most common causes: hepatitis, biliary atresia, and choledochal cyst. In all three conditions, the hepatic echotexture is diffusely coarse and hyperechoic, but this appearance may be seen in a variety of hepatic inflammatory, obstructive, and metabolic processes...
January 2000: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Y Hamada, A Tanano, M Sato, Y Kato, K Hioki
A case of choledochal cyst (CC) antenatally diagnosed at 29 weeks' gestation is reported. Rapid enlargement of the cyst soon after delivery resulted in complete gastric outlet obstruction (GOO). The lesion was treated by external drainage as a temporary maneuver, with delayed cyst excision and hepaticoduodenostomy at the hepatic hilum performed at 81 days of age. Surgical treatment of CC in early infancy has been reported to be safe and effective. However, delayed primary excision would be an alternative procedure, especially in rare cases showing rapid enlargement resulting in GOO, since this choice has the potential advantage of allowing weight gain and improved nutritional status without risking interim complications due to the drainage procedure...
July 1998: Pediatric Surgery International
W Y Lin, C C Lin, S P Changlai, Y Y Shen, S J Wang
Technetium Tc-99m disofenin cholescintigraphy (CS) and ultrasonography (US) are two major clinical methods used in differentiating biliary atresia (BA) from neonatal jaundice. To compare the diagnostic utility of these two modalities, 66 patients with neonatal cholestasis (15 BA, 3 choledochal cyst (CC), 32 neonatal hepatitis, 13 prolonged jaundice, 2 total parenteral nutrition, and 1 sepsis) underwent Tc-99m disofenin CS and US. The diagnostic sensitivity, specificity, and accuracy of CS in differentiating BA from other forms of neonatal jaundice was 100%, 87...
1997: Pediatric Surgery International
C Y Yeung, H C Lee, F Y Huang, M Y Ho, H A Kao, D C Liang, C H Hsu, H Y Hung, P Y Chang, J C Sheu
UNLABELLED: Pancreatitis in children is not common and can be associated with severe morbidity and mortality. We encountered 43 children, ranging in age from 2 to 18 years, with pancreatitis over the past 10 years. The diagnosis of pancreatitis was made in those patients who showed: (1) significant intra-operative pathology or; (2) clinical findings of pancreatic inflammation and laboratory confirmation. More than one third (16 cases) of the cases were due to trauma, other causes included systemic disease (10), structural disease (8), and toxins or drugs (4)...
June 1996: European Journal of Pediatrics
P Dillon, D Belchis, T Tracy, R Cilley, L Hafer, T Krummel
The expression of the inflammatory adhesion molecules intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and endothelial leukocyte adhesion molecule-1, was studied in six infants with biliary atresia using an immunoperoxidase technique on frozen sections. Controls consisted of five patients with various conditions including total parenteral nutrition-induced cholestasis, choledochal cyst, viral hepatitis, metastatic carcinoma, and thrombotic thrombocytopenic purpura. None of the patients were in liver failure...
August 1994: American Journal of Pathology
H Takiff, E W Fonkalsrud
Seventy-seven children less than 19 years old underwent cholecystectomy during a 12-year period at UCLA Medical Center. Forty-four had calculous cholecystitis; five had acalculous cholecystitis; and 28 underwent cholecystectomy with other major biliary surgery. In more than half of the patients with calculous cholecystitis, a cause for cholelithiasis could be identified, most commonly total parental nutrition use. Those without an identifiable etiology were all females, were older, were generally obese, had a family history of gallbladder disease and had a higher likelihood of adult-life symptomatology...
June 1984: American Journal of Diseases of Children
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