Nida Mirza

By Nida Mirza Shaikh

Gall stones is a known entity in adults, but are considered uncommon in pediatric population, however in the recent years, mainly with wide spread use of ultrasonography, cholelithiasis in children is being frequently reported. Etiology of gall stones in children is not similar to adults. Pigment stones are the most frequently seen in children with hemolytic disease as the most common cause, however with the increase in obesity in children there is also rise in cholesterol stones. Many other causes like drugs, congenital hepatobiliary malformation and genetic causes are to be kept during evaluation of gall stones. Management of gall stones need a proper and timely work up for the causes of cholelithiasis is necessary in children. Surgical management with laparoscopic cholecystectomy is the treatment of choice in most of the cases however the timing of surgery should be optimized case to case basis.

Part of the book: Gallstones

By Nida Mirza

Drug-induced hepatotoxicity is common in clinical settings, one of the commonly used drugs leading to liver injury is paracetamol. It is a commonly used analgesic and antipyretic drug. The toxicity of paracetamol has been described in accidental, iatrogenic, and intentional ingestion; also, the extent of liver injury varies from person to person depending on host factors, nutritional status, age, etc. The toxicity of paracetamol is not usually recognized by clinicians as initially, the symptoms are subtle. There is a specific antidote available for paracetamol-induced liver injury to prevent acute liver failure; however, it needs to be given time for proper action, therefore a strong clinical suspicion is to be taken when there is no proper history of ingestion.

Part of the book: Hepatotoxicity