Chronic Liver Disease in pediatric: a case presentation and discussionDr Abdalla M. Gamal
A presentation from a tutorial about an interesting case that came to the Pediatric Department of Sebha Medical Center and was imaged by the Radiology Department.
The tutorial was a joint effort between Dr Zeinab Salem Ali (from Pediatric Department) and me (from Radiology Department). In her slides, Dr Zeinab presented the case history, examination, investigations, differential diagnosis and discussed the clinical presentation, investigations and management for chronic liver diseases in pediatric patients.In my slides, I discussed the definition, etiology, natural history of this condition and explained the role of imaging in its diagnosis.
These are my slides after some modifications. I added an aknowlegement page to illustrate Dr Zeinab effort and to thank Dr Khaled Aljasem from Pediatric Department for his effort in revising the original presentations and the constructive feedback he provided which improved the quality of the presented material. Then I added a summary for the parts Dr Zeinab has presented to make this powerpoint presentation complete.
This presentation was presented by Dr Zeinab Salem (from Pediatric Department) and me in a joint tutorial between Pediatric Department and Radiology Department of Sebha Medical Center.
Chronic Liver Disease in pediatric: a case presentation and discussionDr Abdalla M. Gamal
A presentation from a tutorial about an interesting case that came to the Pediatric Department of Sebha Medical Center and was imaged by the Radiology Department.
The tutorial was a joint effort between Dr Zeinab Salem Ali (from Pediatric Department) and me (from Radiology Department). In her slides, Dr Zeinab presented the case history, examination, investigations, differential diagnosis and discussed the clinical presentation, investigations and management for chronic liver diseases in pediatric patients.In my slides, I discussed the definition, etiology, natural history of this condition and explained the role of imaging in its diagnosis.
These are my slides after some modifications. I added an aknowlegement page to illustrate Dr Zeinab effort and to thank Dr Khaled Aljasem from Pediatric Department for his effort in revising the original presentations and the constructive feedback he provided which improved the quality of the presented material. Then I added a summary for the parts Dr Zeinab has presented to make this powerpoint presentation complete.
This presentation was presented by Dr Zeinab Salem (from Pediatric Department) and me in a joint tutorial between Pediatric Department and Radiology Department of Sebha Medical Center.
Dear Viewers,
Greetings from “ Surgical Educator”
Today I have uploaded a video on one of the congenital causes for obstructive jaundice- Biliary Atresia. In this episode, I am discussing about the etiology, types, clinical features, investigations, treatment and surgical outcome of Biliary Atresia. I hope you will enjoy the video. You can watch all my surgical teaching video casts in the following link: surgicaleducator.blogspot.com.
Drs. Penzler, Ricker, and Ahmad’s CMC Abdominal Imaging Mastery Project: Augu...Sean M. Fox
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Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: Septembe...Sean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
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Information about Diverticular disease by Dr Dhaval Mangukiya.
Details of Diverticular disease, Differential Diagnosis, CT Scan Protocol, Point to look in CT, Options, Indications for Elective Surgery, Exploraion, Primary Resection, Opinion, Management etc.
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
https://drdhavalmangukiya.com/
Wilsons disease and hepatitis dr. abhamoni baroSanjeev Kumar
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Panelists: Prakash Vaidya, Harshad Devarbhavi, Seema Alam
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
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Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
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This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
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This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
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For more information, visit-www.vavaclasses.com
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
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Bio-prospecting tools for drug discovery,
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1. Neonatal cholestasis : How to proceed?
Presenter:
Avinash Khade - LTMGH, Mumbai
Moderator:
S K Yachha – Pediatric Gastroenterologist
SGPGI, Lucknow
Panelists:
Malathi Sathiyasekaran – Pediatric Gastroenterologist,
Kanchi K C Trust Hospital, Chennai
Girish Gupte - Pediatric Hepatologist,
Birmingham Children's Hospital, UK
Ashley D'cruz -Pediatric Hepatobiliary Surgeon,
Narayana Hrudayalaya, Bangalore
2. Neonatal cholestasis –
How to proceed?
Dr. Avinash Khade
Registrar,
Under guidance of
Dr. Alka Jadhav
L.T.T.M.C. SION, MUMBAI 22
3. •
•
•
•
•
1 month 20 days old girl child
1st by birth order
Product of a non consanguineous marriage
Maratha community
Exclusively breastfed
4. Chief complaints
• Progressively increasing yellowish
discoloration of skin and eyes since day 5 of
life.
• Intermittent Clay colored stools
• Excessive irritability
• No other significant history
5. On examination
• She was deeply icteric with some pallor.
• Anthropometry wise well grown with weight
around median and length between -1SD &
median. Head circumference normal.
• Hepatomegaly with liver span of 8 cms , firm
consistency and smooth surface
• Splenomegaly of 4 cm , firm consistency.
6. History
• No h/o fever, lethargy, irritability, refusal to
feed
• No h/o convulsion
• No h/s/o defective vision, hearing
impairment.
• No h/o recurrent respiratory infections.
• No h/o constipation.
• No h/o abdominal distension, bleeding from
any sites, altered sensorium
8. Investigations
• Hemoglobin of 7.7g/dl, Total WBC count
12,700/cmm and 3.2 lakh platelets.
• LFT showed Total serum bilirubin of 7.9 mg% with
direct of 4.6 mg%.
• SGOT - 654 and SGPT- 236.
• ALP - 445
• GGT - 262.
• INR - 1.06.
• Thyroid function tests were normal.
• Urine reducing substances was negative.
9. • TORCH screening revealed
CMV IgM positivity (2.34).
• Ophthal for chorio-retinitis normal.
• USG brain : No Hydrocephalus
• BERA - awaited
• CMV -viral load awaited
10. Ultrasonography showed mild hepatomegaly
with no alteration of echo texture and normal
CBD without any malformation of the biliary
system. The gall bladder could be visualized.
11. • HIDA scan showed good uptake but poor
excretion of the same.
• MRCP was suggestive of hypoplastic gall
bladder with no visualization of LHD, RHD and
CHD and CBD, findings s/o biliary atresia.
12. • Child was operated with Kasai`s procedure.
• Liver biopsy : nodules separated by thick fibrous bands
composed of ballon hepatocytes. Intracanalicular and
ductular cholestasis. Fibrous septa shows bile duct
proliferation with chronic infiltrate s/o secondary
biliary cirrhosis
• She was subsequently started on Gancyclovir for CMV
hepatitis.
13. Messages
• We wish to present this case so as to highlight the
importance of aggressively screening for
correctable causes like biliary atresia.
• In this case, attributing the cholestatic jaundice to
CMV alone could have caused us to miss the biliary
atresia.
• It also highlights that CMV infection is very
common be it congenital or acquired , so other
possibilities should be ruled out before labeling a
diagnosis of CMV hepatitis
14. How to do it ?
3 wk baby, jaundice
Does the urine stain diapers: yes
● What is the stool color ?
●
Yellow
Confirm
Confirm
Confirm
Pale
Not sure
Worried, fast track
+
Nuclear scan
LFT
Ultrasound
Liver biopsy
15. A few but precise investigations
Pale stools
Consider biliary atresia
Ultrasonography: best bet for choledochal cyst
Liver biopsy: best for diagnosis
± HIDA scan: to rule out biliary atresia
Endoscopic retrograde cholangiography
