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Pediatric Gastroenterology & Hepatology For Undergraduate

Pediatric Gastroenterology & Hepatology For Undergraduate. Dr Hatem Hussein Professor of Pediatrics Associate member of Royal College Of Paed.&Child Health-UK Zagazig Faculty of Medicine-Egypt Mar. 2008. PORTAL HYPERTENSION. Definition: PVP> 10 mmHg. Aetiology:

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Pediatric Gastroenterology & Hepatology For Undergraduate

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  1. Pediatric Gastroenterology & Hepatology For Undergraduate Dr Hatem Hussein Professor of Pediatrics Associate member of Royal College Of Paed.&Child Health-UK Zagazig Faculty of Medicine-Egypt Mar. 2008

  2. PORTAL HYPERTENSION Definition: PVP> 10 mmHg. Aetiology: -Prehepatic primary,sepsis,invasions,uvc.. -Hepatic a- Presinusoidal malig.& Fibrosis b- Sinusoidal Cirrhosis c- Post- sinusoidal VOD

  3. P HBN cont. - Post- hepatic a- Hepatic v. Budd- Chiari b- IVC related c- TR d- CHF e- Pericardial eff. And constrictive pericar.

  4. P HBN cont C/P: 1- Collaterals; Varices, caput, hemorrohides, lienorenal sequale. 2- Splenomegaly 3- Ascites mechanisms!! 4- Liver Normal, shrunken or enlarged

  5. P HBN cont Investigations: 1- Aetiological investigations. 2- Abdominal ultrasonography 3- Duplex studies 4- Upper endoscopy Treatment: 1- Aetiological treatment 2-beta blockers 3-Injection versus banding 4-supportive

  6. LIVER CIRRHOSIS Definition: Chronic and diffuse liver dis. ccc by degenerat.& necrosis of liver cells followed by haphazard regeneration nodules. Aetiolgy: 1-Post hepatitic 2-Alcholic 3-Nutritional 4-Biliary 5-Cardiac 6-Metabolic

  7. LIVER CIRRHOSIS cont. C/P: 1- Compensated stage: non specific 2- Decompensated: LCF picture, - CNS Encephalopathy - GIT bleeding - CVS hyper dynamic - Skin Spider naevi,, palmar erythrema - Jaundice - Ascites, LL edema - Foetor hepaticus

  8. LIVER CIRRHOSIS cont. Investigations: 1- LFT’s 2- US, CT, MRI, Endoscopy 3- Biopsy when? 4- etiological diagnosis Complications: Portal HPN Hepato-pulmonary syndrome Hepato-renal syndrome Malignancy Treatment : Supportive Etiological Orthotopic transplantation

  9. ASCITIS Types Transudate Exudate Hemorrhagic Chylous Urinary Methods of detection

  10. GIT BLEEDING UPPER above treitz ligament LOWER below it UPPER CAUSES - oseophageal - gastric - duodenal - general causes

  11. GIT BLEEDING cont. LOWER CAUSES - massive from upper - intestinal -anal - IBD -GE- Malignancy & General causes

  12. GIT BLEEDING cont. Management: Emergency measures: admission, ABC, IV line, Consider transfusion. Etiology work up: from history, examination, investigations esp. endoscopy, U/S, PT and PTT, CBC,LFT’s

  13. GIT BLEEDING cont. Treatment of cause: 1- OV vasopressin, octrotide Sungestaken-blackmore tri. Tube Injection versus banding Emergency shunt Treat encephalopathy 2- Treat bleeding disorders and leukem. 3- PPI for Peptic ulcers 4- Operative for intuss., volv, polyposis or piles

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