Concluded Case

Viral hepatitis in children

A 6yrs male with jaundice (for 3 day) with mild pain abdomen and generalized weakness. Kindly comment on the management??

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All blood reports suggestive of viral hepatitis with grossly deranged liver enzyme specially alkaline phosphatase label is very high. Serum bilirubin high with relatively high indirect one. USG. Liver enlarged with thickened wall of gall bladder with biliary sludge. If seems to be case of viral hepatitis Go for viral marker for hepetitis B , hepatitis A. Rule out haemolytic anaemia as indirect bilirubin high.because it is not the time to stamp as Gilbert Syndrome. Now the reason for raised serum alkaline phosphatase which is mainly raised due obstructive jaundice may be due to cholestasis due to oedema of the biliary system due to ascending cholangitis and ? acalculus cholecystis with biliary sludge. Treatment A. Hospitalisation B. Rest to liver by supplement with 10% dextrose and maintain hydration C. Steroid by mouth or parenteral ( wysolone) to reduce the intra hepatic oedema D. Multivitamins infusion E maintain vitals including orientation and label of conciousness Repeat LFT after 5 days Other liver support like Udiliv etc.

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All blood reports suggestive of viral hepatitis with grossly deranged liver enzyme specially alkaline phosphatase label is very high. Serum bilirubin high with relatively high indirect one. USG. Liver enlarged with thickened wall of gall bladder with biliary sludge. If seems to be case of viral hepatitis Go for viral marker for hepetitis B , hepatitis A. Rule out haemolytic anaemia as indirect bilirubin high.because it is not the time to stamp as Gilbert Syndrome. Now the reason for raised serum alkaline phosphatase which is mainly raised due obstructive jaundice may be due to cholestasis due to oedema of the biliary system due to ascending cholangitis and ? acalculus cholecystis with biliary sludge. Treatment A. Hospitalisation B. Rest to liver by supplement with 10% dextrose and maintain hydration C. Steroid by mouth or parenteral ( wysolone) to reduce the intra hepatic oedema D. Multivitamins infusion E maintain vitals including orientation and label of conciousness Repeat LFT after 5 days Other liver support like Udiliv etc.

Thank you Dr Mrinal
0

Looks VIRAL HEPATITS Do viral marker such as HCV HEV IGM HAV IGM Rull out haemolytic jaundice as indirect bilirubin is high T/t Admit patient Iv fluids for hydration Glucose suppliment Luv 52 TDS Fat free diet Add wysolone as bili is quite high Repeat LFT after 3 days

Admit and manage .Hepatocellular failure, cholestasis, due to inf hepatitis. Rule out other causes of hepatitis like drugs, autoimmune, metabolic. Liver supportive treatment.

Acute Viral Hepatitis, admission required, symptomatic treatment, do PT/PC, INR for prognosis.

SUGGESTIVE OF VIRAL HEPATITIS NEEDS. FURTHER EVALUATION

Acute viral Hepatitis Symptomatic treatment Check PT INR

Adjuvant along Allopathic Medicine Syp Jigreen 5 ml tds,

ACute viral Hepatitis Advise refer to Gastroenterologist

1.Repeat LFT, PT,INR,R/o Hemolytic causes,Dengue check,

Thanks dr.Sabista naaz
0

Cholestatic viral hepatitis Ref to Gastroenterologist

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