新生児肝炎開腹症例の再検討  [in Japanese] Reevaluation of the Patients of Neonatal Hepatitis Underwent Exploratory Laparotomy  [in Japanese]

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Abstract

当科で開腹診断を受けたNH症例6例について各所見を同時期のBA症例39例と比較し, 鑑別に有用たる指標の有無を再検討した.その結果右季肋下肝最大径, 便シュミット試験の陽性率, γ-GTP, リポ蛋白X, 血清総蛋白, 血清総コレステロール, アルカリフォスファターゼ, GOT, 白血球数について両症例間に有意差が認められ, 鑑別に有用であったことが判明した.BAの治療には早期手術が大切であることはいうまでもないが, 一方NH症例に対しては少しでも不要な開腹を避ける努力も重要と思われ, その際にはこれらの項目の検討が診断の一助となり得ると考えられる.

Neonatal Hepatitis (NH) occasionally resembles biliary atresia (BA) on its clinical symptoms, and some special tests are used to differentiate these two diseases. Examination of duodenal fluid is currently accepted to be the most reliable method to make the diagnosis of BA. From July 1977 to August 1988, we performed exploratory laparotomies on 6 cases of NH in whose duodenal fluid bile juice was not detected. We compared the physical findings and laboratory data of these patients with those of patients with BA, and selected the examinations which were retrospectively useful to differentiate these two very similar conditions. As a result, maximum length of liver at the right hypochondrial region, Schmidt's test of stools, γ-GTP, lipoprotein-X, serum total protein, serum total cholesterol, serum alkaline phosphatase, GOT, and WBC were found to be useful for this purpose. These examinations can be done routinely, and can ease the diagnosis of cholestatic infants in whose duodenal fluid bile juice was not detected.

Journal

  • Journal of the Japanese Society of Pediatric Surgeons

    Journal of the Japanese Society of Pediatric Surgeons 26(6), 1170-1174, 1990

    The Japanese Society of Pediatric Surgeons

Codes

  • NII Article ID (NAID)
    110002102079
  • Text Lang
    JPN
  • ISSN
    0288-609X
  • Data Source
    NII-ELS  J-STAGE 
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