A 12-year-old boy presented with jaundice, abdominal distension and leg edema (original) (raw)
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Bangabandhu Sheikh Mujib Medical University Journal
This article has no abstract. The first 100 words appear below: A 10-year-old immunized girl, 6th issue of consanguineous parents, presented with the complaints of jaundice for the last 2 years and deterioration of school performance for the same duration. She also had generalized itching for the last 6 months. She had no history of altered sleep pattern, any gastrointestinal bleeding, surgical or dental procedures, history of blood and blood products transfusion, taking any offending drugs, sib death or family history of such type of illness.
Bangabandhu Sheikh Mujib Medical University Journal
This article has no abstract. The first 100 words appear below: A 14-year-old boy, 4th issue of his non-consanguineous parents got admitted in the Department with the complaints of gradual abdominal distension and occasional abdominal pain since two years of his age. There was no history of jaundice, upper gastrointestinal bleeding, fever, contact with a known case of tuberculosis patient or family history of such type of illness. On examination, he was alert, anicteric, no facial dysmorphism, vitally stable, no stigmata of chronic liver disease and anthropometrically well thrived.
Unusual cause of cholestatic jaundice in a young immunocompetent male
Journal of Clinical and Experimental Hepatology, 2016
A 18-year-old boy with no previous comorbidities presented with jaundice, fever, and loss of weight and appetite of one-month duration. He had no previous history of long-standing fatigue, jaundice, ascites, upper gastrointestinal bleeding, or encephalopathy. Based on chest skiagram findings of nonhomogenous opacities in right upper lobe ([ 2 8 _ T D $ D I F F ] Figure 1; arrow), he was started on antitubercular therapy (ATT) in an outside medical facility. Following this[ 2 9 _ T D $ D I F F ] , he had worsening of jaundice and four weeks later developed progressively increasing abdominal distension[ 3 0 _ T D $ D I F F ]. On examination, he was icteric, and had pallor and firm palpable lymph nodes in cervical and axillary region along with firm hepatomegaly and ascites. Investigations revealed normochromic, normocytic anemia with [ 3 1 _ T D $ D I F F ] hemoglobin of 9.9 g/dl and elevated erythrocytic sedimentation rate of 55 in the first hour. The total leukocyte count [ 3 2 _ T D $ D I F F ] (17,600 cells/mm 3 [ 1 0 _ T D $ D I F F ]) was raised with an absolute eosinophil count of 5456 cells/mm 3 [ 3 3 _ T D $ D I F F ]. The platelet count was normal. Stool routine microscopy did not show any parasite on consecutive three stool samples. Acid[ 3 4 _ T D $ D I F F ]-fast bacilli (AFB) were not detected in the sputum examination[ 3 5 _ T D $ D I F F ]. Liver [ 2 _ T D $ D I F F ] Figure 2 CECT abdomen: enlarged liver that shows heterogenous attenuation, multiple hypodense lesions (white arrows[ 3 _ T D $ D I F F ]), and dilated intrahepatic biliary radicles (black arrows). Figure 1 Chest X-ray: nonhomogenous opacities in right upper lobe (arrows).
An 11-year-old boy with chronic diarrhea and weight loss
Bangabandhu Sheikh Mujib Medical University Journal, 2020
An 11-year-old boy presented with 15 months history of diarrhea with up to 10-20 times small volume stool daily with mucus. It was associated with a feeling of incomplete defecation and excessive straining. The frequency of diarrhea increased to 20-30 times per day over the last 8 months. Subsequently, he developed fecal incontinence, for which he couldn't attend his school. He also had a history of significant weight loss in the last 7 months. According to his mother's statement , his body weight was reduced to 64 kg from 77 kg during this illness. In spite of receiving several antibiotics and antidiarrheal medications prescribed by a registered physic-cian, his symptoms had not resolved. He had no history of constipation, self-digitation, per rectal bleeding, fever, anal or abdominal pain, oral ulcer, skin lesion, joint pain, TB contact, and no significant family history. There was no evidence of any significant visible rectal pro-lapse. During his course of illness, he was symptom-free for 4 months irrespective of any treatment. The findings of the physical examination were unremarkable. He was mildly pale, afebrile, not dehydrated, skin survey was normal, BCG mark was present, lymph nodes not enlarged and vitally stable. His anthropometric measurements were at 97 th percentile for weight (59 kg), at 95 th to 97 th percentile for height and body mass index for age at 95 th to 97 th percentile. The abdomen was soft and non-tender with no organomegaly or ascites, bowel sound was present. Perianal findings and digital rectal examinations were unremarkable. Other syste-mic examinations revealed no abnormality.
Fever and Jaundice in a Previously Healthy Teenager
Clinical Pediatrics, 2016
A previously healthy 14-year-old girl was transferred to our facility from an outside hospital with a 10-day history of nausea, malaise, intermittent fever (peak 39.5°C), and fatigue. In the 72 hours prior to admission, she had developed progressive yellowing of the skin and scleral icterus. She had not traveled recently and her immunizations were up-to-date. She denied being sexually active or using illicit substances. She was a well-developed Caucasian adolescent who on initial presentation appeared fatigued and jaundiced. Vital signs on admission: temperature, 38.8°C; heart rate, 96 beats per minute; respiratory rate, 18 breaths per minute; and blood pressure, 112/58 mm Hg. Her physical examination revealed scleral icterus, pharyngeal erythema with tonsillar exudates, anterior cervical lymphadenopathy, and right-sided abdominal tenderness. The liver edge was palpable at 1 cm below the right costal margin. Laboratory evaluation from the outside hospital revealed transaminase elevation and elevated serum bilirubin levels (table 1