Spectrum of Hepatobiliary Disease Among Children in Northeast India

Background: The spectrum of hepatobiliary disorders in children is different from those of adults and include a variety of acute and chronic disorders and these variations are attributable to different factors and they vary with geographical area.Therefore, there is need of such study to find out the spectrum of hepatobiliary diseases in different areas. Aim:To find out the existing pattern of hepatobiliary disorders in children presenting at a tertiary care center in North East India. Material and methods: This hospital based retrospective audit of our experience with liver disease in children was done from March 2010 to January 2012 at Department of Pediatrics, Gauhati Medical College and Hospital. Children aged between 1 month to 13 years with signs and symptoms suggestive of hepatobiliary disorders were included in this study. Diagnosis of hepatobiliary disease was made on clinical grounds and appropriate laboratory investigations. Observation and Results:Out of 70 children, 50 (71.4%) were boys and 20 (28.57%) were girls. 35 (50%)children presented with acute hepatitis, 20 (28.57%) with neonatal cholestasis syndrome, 10 (14.28%) presented with chronic liver disease. Out of 35 children with acute hepatitis, 25 (35.7%) were because of hepatitis A. 6 (8.75%) children presented with acute liver failure due to hepatitis A infection. Out of 10 children with chronic liver disease7 (70%) were because of Wilsons disease. Out of 20 children with neonatal cholestasis syndrome, 9 (12.8%) children presented with extrahepatic biliary atresia (EHBA) and 7 (10%) children presented with neonatal hepatitis and 4 (5.71%) presented with Galactosemia. These children presented late. 14 presented after the age of 4 months, only 4 presented before the age of 2 months. Conclusion:High incidence of hepatitis A infection indicates the urgent need of increasing awareness of personal hygiene, use of safe drinking water and timely hepatitis A vaccination. There is need of early diagnosis of cholestasis.