Cirrhosis of the liver in children: complicated forms

The protracted course of cirrhosis of the liver in childhood leads to serious damage to the heart and blood vessels, kidneys, gastrointestinal tract and pancreas. The most serious and often irreversible is hepatic coma.   

Heart disease in children with liver cirrhosis

  • With this disease, blood circulation in the hepatic vessels is disturbed, hypervolemia develops , and the overall level of peripheral resistance decreases.
  • In the stage of decompensation of liver cirrhosis, when the content of toxins in the blood increases, which reduce the tone of the vascular system, as a rule, heart failure develops. 

Gastrointestinal disorders in a child with liver cirrhosis

  • The vast majority of patients with cirrhosis in childhood experience problems from the pancreas, complain of characteristic pains in the epigastric region and right hypochondrium, “radiating” to the back.  
  • Almost 40% of children with this serious liver damage have cholecystitis, bile duct dyskinesia, atrophic gastritis.
  • 10% of young patients with symptoms of liver cirrhosis suffer from stomach ulcers.  

Kidney pathology in children with cirrhosis

  • The severe course of the disease inevitably leads to disturbances in the work of the urinary system, the secretory function of the tubules and the ability of the glomeruli to filter decreases, against the background of which hepatorenal syndrome develops.
  • The suffering of the urea excretory function is manifested by oliguria, hematuria, cylindruria and albuminuria.
  • It all starts with dyspeptic disorders, and ends with severe symptoms of uremia (tachycardia, vomiting, bleeding, etc.), which is a consequence of nephrosclerosis.

Circulatory system with cirrhosis of the liver in children

  • In parallel with cirrhosis, the process of formation of hypocoagulation always takes place .
  • The affected liver cannot synthesize enough blood clotting factors.
  • The content of fibrinolysis increases .
  • The vessel wall becomes more permeable.
  • Thrombocytopenia develops, and against its background – thrombocytopathy .
  • With biliary cirrhosis of the liver, cytopenia is characteristic .
  • A decrease in the protein synthesis function of the affected liver gives rise to iron deficiency , vitamin deficiency (groups B, E), a lack of zinc, copper and a number of other microelements.

Nervous system disorders in a child with liver cirrhosis

There is a special term “portal systemic encephalopathy”, which unites all neurological problems in cirrhosis of the liver in childhood . It includes: 

  • mental disorders (insomnia, alternating euphoria with apathy, learning difficulties, lethargy and coma);
  • neuromuscular disorders (tremors, speech disorders, ataxia, rigidity, opisthotonus )
  • hyperventilation;
  • epilepsy;
  • hyperammonemia .

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