RT Book, Section
A1 Squires, James E.
A1 Squires, Robert H.
A2 Kline, Mark W.
SR Print(0)
ID 1182908966
T1 Evaluation of the Infant and Child with Liver Disease
T2 Rudolph's Pediatrics, 23e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259588594
LK accesspediatrics.mhmedical.com/content.aspx?aid=1182908966
RD 2023/04/01
AB Evidence  of  liver  disease  in  children  will  take  different  forms.  Children  can  present  with  clinical  manifestations  of  acute  or  chronic  liver  disease.  Physical  findings  are  the  most  obvious  and  include  jaundice,  hepatomegaly  (with  or  without  splenomegaly),  and  ascites.  More  subtle  physical  findings  in  chronic  liver  disease  include  prominent  superficial  abdominal  vessels  and  hemorrhoids  seen  with  portal  hypertension,  palmar  erythema  (Fig.  414-1),  spider  nevi  (Fig.  414-2),  digital  clubbing,  isolated  splenomegaly,  xanthomas,  and  excoriations  of  the  skin  due  to  pruritus.  Children  may  also  be  identified  as  having  liver  disease  in  the  absence  of  obvious  physical  findings.  For  example,  biochemical  tests  obtained  to  assess  patients  with  nonspecific  symptoms  may  reveal  abnormalities  in  liver-related  enzymes  or  liver  functions.