Jaundice is one of the diseases that scare parents. It is vital to distinguish temporary jaundice in the neonatal period and jaundice caused by liver-biliary tract diseases.
In cases where diagnosis and treatment are delayed, chronic liver failure may occur. Professor of Pediatric Gastroenterology Department of Memorial Ataşehir and Bahçelievler Hospitals. Dr. Ayşe Selimoğlu gave information about liver failure in babies and children and made suggestions to parents.
Investigate the cause of your child's mood changes
Liver failure; It is the deterioration of liver functions to a level that cannot maintain normal life. Liver failure can be seen in all age groups, starting from the neonatal period to adulthood. The emergence of jaundice with or immediately after complaints such as weakness, anorexia, vomiting, abdominal pain in a child without a known liver disease may be the first sign of acute liver failure. Persistent vomiting, mood changes, excessive sleepiness, insomnia, restlessness or meaningless speech accompanying jaundice may also be signs of liver failure.
Liver failure can slow your child's growth
In a child diagnosed with acute hepatitis, the gradual increase in complaints, especially jaundice, and inexplicable behavioral changes are important. Nosebleeds, red rashes and bruises on the body are also other signs of acute liver failure. Sometimes a rapidly developing coma picture can be seen in the patient.
Liver failure may also develop in a child followed up for any chronic liver disease. In this case, the emergence of jaundice, increased fatigue, swelling in the abdomen and legs, nosebleed or blood from the mouth are important symptoms. Liver failure sometimes progresses without symptoms; It prevents the child's growth, decreases his school success, and emerges with changes in temperament. For this reason, liver tests should be checked if there is severe weakness, loss of appetite and growth retardation in a child without jaundice.
Check not only skin but also urine color
Most of the jaundice seen in the neonatal period are transient jaundice unrelated to liver disease. However, among the jaundice seen in the first 3 months, there are also those that occur due to liver disease and it is very important to diagnose and treat them early. While distinguishing jaundice caused by liver disease from others, parents should control not only the skin color but also the baby's urine and stool color. Although there is jaundice in the body and eyes in other causes of jaundice, the color of the urine is light, while the color of the urine is dark yellow in liver disease, and the stool color may turn white in severe cases.
Early diagnosis is vital
Early diagnosis is important in cases of jaundice that occur due to liver disease. Especially in babies with bile duct obstruction, if the bile duct is not opened surgically within the first 2 months, cirrhosis is inevitable. In addition, if the appropriate diet and treatment cannot be given in jaundice caused by some metabolic diseases, a similar result will develop. Liver and spleen enlargement occurs over time in liver diseases that are not diagnosed and treated early, and the patient enters liver failure with fluid accumulation and severe bleeding in the abdomen.
Transplantation timing is important in chronic liver failure.
In acute liver failure, full recovery can be achieved with advanced life support and special treatments given in intensive care conditions depending on the cause of the failure. However, liver transplantation is the only treatment option in children who do not respond to treatment. In acute insufficiency, in cases where liver transplantation cannot be performed, the risk of death is over 70%, while the chance of life with liver transplantation is above 90%. Timing of liver transplantation is a very critical decision. The goal should always be to keep the child alive with his own liver. The basic principle in experienced centers is to wait long enough for the liver to recover, but to be able to perform liver transplantation in time before other organ damage develop.
In chronic liver failure, if there is no special treatment option for the disease, the only chance of life is with liver transplantation. Favorable results are obtained with liver transplantation. The key to success is not to delay liver transplantation too long. Living with liver failure for a long time adversely affects the growth, intelligence, social and emotional development of the child.
Do not delay to consult a doctor in these situations:
- If you notice yellowing of your child's skin and eyes
- If your newborn's jaundice lasts longer than 15 days, even if it has been seen by a doctor before
- If there is a darkening in the color of the urine with jaundice, white in the stool color
- If your baby with jaundice is not sucking active, sluggish, overly sleepy or extremely restless
- If there is prolonged bleeding in the navel or places where blood is taken
- If abdominal swelling is noticeable and accompanying vomiting is present, you should consult a specialist immediately.
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