Advertisement

Pädiatrie pp 872-918 | Cite as

Krankheiten der Leber

  • M. Becker
  • M. Burdelski
  • D. Feist
  • K. Pittschieler
  • S. Wirth
  • T. Lang
  • J. Deutsch
  • B. Rodeck
  • M. Melter
  • A. Ballauff
Chapter
  • 171 Downloads

Zusammenfassung

Der durch die hepatische Mikrozirkulation definierte Leberazinus ist die funktionelle Einheit der Leber. Der Austausch von gelösten Bestandteilen zwischen dem Blut und den Hepatozyten folgt einem Gradienten zwischen dem Portalfeld und der Zentralvene (Abb. 114.1). Zone 1 stellt die Hepatozyten dar, die der Zentralachse am nächsten sind, Zone 2 die intermediäre Region des Azinus, und Zone 3 ist die Region, in der die Hepatozyten am weitesten von ihrer afferenten Blutversorgung entfernt sind. Die Differenzierung der Parenchymfunktionen in Zonen ist bei der Geburt nicht vollständig. So ist bei Neugeborenen die Gallensäurenaufnahme im Azinus vermindert, so daß der Konzentrationsgradient zwischen Zone 1 und 3 nicht erreicht wird. Auch die hepatische Zonierung für den Kohlenhydratstoffwechsel tritt erst nach der Geburt ein. Die Entwicklung einer funktionellen Heterogenität der Zonen nach der Geburt ist teilweise auf die veränderte Leberdurchblutung nach der Geburt zurückzuführen.

Literatur

  1. Allen KJ, Whitington PF (1998) Biochemical assessment of neonatal liver function. In: Polin RA (ed) Fetal and neonatal physiology. Saunders, Philadelphia, pp 1530–1552Google Scholar
  2. Andrew M, Paes B, Johnston M (1990) Development of hemostatic system in the neonate and young infant. J Pediatr Hematol Oncol 12: 95–104CrossRefGoogle Scholar
  3. Becker M (1998) Cbreath tests for measurement of liver function. GUT 43 (suppl 3): pp 25–27CrossRefGoogle Scholar
  4. Bezerra JA (1998) Liver development: a paradigma for hepatobiliary disease in later life. Semin Liver Dis 18: 203–216PubMedCrossRefGoogle Scholar
  5. Burdelski M, Schütz E, Nolte-Buchholtz S, Armstrong VW, Oellerich M (1996) Prognostic value of the monoethylenglycinexylidide test in pediatric liver transplant candidates. Ther Drug Monit 18: 378–382PubMedCrossRefGoogle Scholar
  6. Jäger-Roman E, Rating D, Platzek T, Helge H (1982) Development of Nmethylase activity measured with the 13C-aminopyrine breath test. Eur J Pediatr 139: 129–134PubMedCrossRefGoogle Scholar
  7. Keffler S, Kelly DA, Powel J, Green A (1998) Population screening for neonatal liver disease: a feasibility study. J Pediatr Gastroenterol Nutr 27: 306–311PubMedCrossRefGoogle Scholar
  8. Krumbiegel P, Domke S, Mörseburg B, Boehm G, Braun W (1997) Maturation of hepatosomal mono-oxygenation and glucuronidation activities in pre- and full-term infants as studied ising the [15N] methacetin urine test. Acta Paediatr 86: 1236–1240PubMedCrossRefGoogle Scholar
  9. Mailer SM (1994) Laboratory assessment of liver function and injury in children. In: Suchy FJ (ed) Liver disease in children. Mosby, St. Louis, pp 269–282Google Scholar
  10. Rabe C, Whitington PF (1994) Xenobiotic-based quantitative liver function tests. In: Suchy FJ (ed) Liver disease in children. Mosby, St. Louis, pp 283–293Google Scholar
  11. Rappaport AM, Wanless IR (1993) Physioanatomic considerations. In: Schiff L, Schiff ER (eds) Diseases of the liver. Lippincott, Philadelphia, pp 1–41Google Scholar
  12. Reichen J (1995) Assessment of hepatic function with xenobiotics. Semin Liver Dis 15: 189–201PubMedCrossRefGoogle Scholar
  13. Balistreri WF (1997) Bile acid therapy in pediatric hepatobiliary disease: the role of ursodeoxycholic acid. J Pediatr Gastroenterol Nutr 24: 573–589PubMedCrossRefGoogle Scholar
  14. Brölsch CE, Burdelski M, Rogiers X et al. (1994) Living donor for liver transplantation. Hepatology 20: 49–55Google Scholar
  15. Bull LN, Varlton VEH, Stricker NL et al. (1997) Genetic and morphological findings in progressive familial intrahepatic cholestasis (Byler’s disease [PFIC] and Byler syndrome). Evidence of heterogeneity. Hepatology 26: 155–164Google Scholar
  16. Emond JC, Whitington PF (1995) Selective surgical management of progressive intrahepatic cholestasis. J Pediatr Surg 30: 1635–1641PubMedCrossRefGoogle Scholar
  17. Helmke K (1996) Die Rolle der bildgebenden Verfahren in der hepatologischen Diagnostik im Kindesalter. Verdauungskrankheiten 14: 28–35Google Scholar
  18. Keffler S, Kelly DA, Powel JE et al. (1998) Population screening for neonatal liver disease: a feasibility study. J Pediatr Gastroenterol Nutr 27: 306–311PubMedCrossRefGoogle Scholar
  19. Kelly DA (1998) Current results and evolving indications for liver transplantation in children. J Pediatr Gastroenterol Nutr 27: 214–221PubMedCrossRefGoogle Scholar
  20. Mc Bride KE (1998) Clinical features of the Alagille syndrome. Frequency and relation to prognosis. J Pediatr Gastroenterol Nutr 26 (A): 580Google Scholar
  21. Muller M, Jansen PL (1997) Molecular aspects of hepatobiliary transport. Am J Physiol 272: 1285–1303Google Scholar
  22. Oda T, Elkahloun AG, Pike BC et al. (1997) Mutations in the human jagged I gene are responsible for Alagille syndrome. Nat Genet 16: 235–242PubMedCrossRefGoogle Scholar
  23. Vree JM de, Jacquemin E, Sturm E et al. (1998) Mutations in the MDR3 gene cause progressive familial cholestasis. Proc Natl Acad Sci USA 95: 282–287CrossRefGoogle Scholar
  24. Bull PC, Thomas GR, Rommens JM et al. (1993) The Wilson’s disease gene is a putative copper transporting P-Type ATPase similar to the Menkes gene. Nat Genet 5: 327–337PubMedCrossRefGoogle Scholar
  25. Dening TR, Berrios GE, Walshe JM (1988) Wilson’s disease and epilepsy. Brain 111: 1139–1155PubMedCrossRefGoogle Scholar
  26. Feist D, Wesch H (1998) Morbus Wilson und seine mannigfaltigen Erscheinungsformen bei Kindern. Pädiat Prax 54: 577–586Google Scholar
  27. Maier-Dobersberger Th, Rack S, Datz Ch et al. (1995) Diagnosis of Wilson’s disease in an asymptomatic sibling by DNA linkage analysis. Gastroenterology 109: 2015–2018PubMedCrossRefGoogle Scholar
  28. Tanzi RE, Petrukhin K, Chernov I et al. (1993) The Wilson disease gene is a copper transporting ATPase with homology to the Menkes disease gene. Nat Genet 5: 344–350PubMedCrossRefGoogle Scholar
  29. Wesch H, Przuntek H, Feist D (1980) Morbus Wilson. Rasche Diagnose und Differenzierung heterozygoter und homozygoter Anlageträger mit 64CuCs2. Dtsch Med Wochenschr 105: 483–488PubMedCrossRefGoogle Scholar
  30. Bellman MH, Hall SM (1983) Aetiology of Reye’s syndrome. Arch Dis Child 58: 670–672PubMedCrossRefGoogle Scholar
  31. Bougnères PF, Rocchiccioli F, Kolvraa S et al. (1985) Medium-chain acylCoA dehydrogenase deficiency in two siblings with a Reye-like syndrome. J Pediatr 106: 918–921PubMedCrossRefGoogle Scholar
  32. Mortimer EA (1987) Reye’s syndrome, salicylates, epidemiology and public health policy. JAMA 257: 1941–1942CrossRefGoogle Scholar
  33. Mowat AP (1993) Reye’s syndrome. In: Liver disorders in childhood, 3rd edn. Butterworth-Heineman, Oxford London Boston, pp 167–179Google Scholar
  34. Crystal RG (s99o) as-antitrypsin deficiency, emphysema, and liver disease. J Clin Invest 85: 1343–1352Google Scholar
  35. Mowat AP (1994) Alphai-antitrypsin deficiency (PiZZ): features of liver involvement in childhood. Acta Paediatr Suppl 393: 13–17PubMedCrossRefGoogle Scholar
  36. Pierce JA (1997) Alphai-antitrypsin augmentation therapy. Chest 112: 872–874PubMedCrossRefGoogle Scholar
  37. Pittschieler K (1991) Liver disease and heterozygous ca-antitrypsin deficiency. Acta Paediatr Scand 80: 323–327PubMedCrossRefGoogle Scholar
  38. Poley JR (1994) Malignant liver disease in alphai-antitrypsin deficiency. Acta Paediatr Suppl 393: 27–32PubMedCrossRefGoogle Scholar
  39. Sveger T (1976) Liver disease in alpha-i-antitrypsin deficiency detected by screening of 200,000 infants. N Engl J Med 294: 1316–1321PubMedCrossRefGoogle Scholar
  40. Sveger T (1994) Screening for alphas-antitrypsin deficiency. Acta Paediatr Suppl 393: 18–20PubMedCrossRefGoogle Scholar
  41. Sveger T, Eriksson S (1995) The liver in adolescents with at-antitrypsin deficiency. Hepatology 22: 514–517PubMedGoogle Scholar
  42. Teckman JH, Qu D, Perlmutter DH (1996) Molecular pathogenesis of liver disease in as-antitrypsin deficiency. Hepatology 24: 1504–1516PubMedGoogle Scholar
  43. Beuers U,Wiedmann KH, Kleber G, Fleig W (1997) Therapie der autoimmunen Hepatitis, primär biliären Zirrhose und primär sklerosierenden Cholangitis. Z Gastroenterol 35: 1041–1049Google Scholar
  44. Bisceglie AM (1998) Hepatitis C. Lancet 351: 351–355CrossRefGoogle Scholar
  45. Conjeevaram HS, Di Biseglie AM (1995) Management of chronic viral hepatitis in children. J Pediatr Gastroenterol Nutr 20: 365–375PubMedCrossRefGoogle Scholar
  46. Debray D, Pariente D, Urvoas E, Hadchonel M, Bernard O (1994) Sclerosing cholangitis in children. J Pediatr 128: 49–56Google Scholar
  47. Gish RG, Lau JYN (1997) Hepatitis C virus: eight years old. Viral Hepatitis Rev 3: 17–37Google Scholar
  48. Johnson PJ, McFarlane IG (1993) Meeting report: international autoimmune hepatitis group. Hepatology 18: 998–1005PubMedCrossRefGoogle Scholar
  49. Johnson PJ, McFarlane JG, Williams R (1995) Azathioprine for long-term maintenance of remission in autoimmune hepatitis. N Engl J Med 333: 958–963PubMedCrossRefGoogle Scholar
  50. Koff ES (1998) Hepatitis A. Lancet 351: 1643–1649CrossRefGoogle Scholar
  51. Krawitt EL (1996) Autoimmune hepatitis. N Engl J Med 332: 897–902CrossRefGoogle Scholar
  52. Lee YM, Kaplan MM (1995) Primary sclerosing cholangitis. N Engl J Med 332: 924–933PubMedCrossRefGoogle Scholar
  53. Manns MP (1993) Viruses and autoimmune liver disease. Intervirology 35: 108–115PubMedGoogle Scholar
  54. Panda SK, Jameel S (1997) Hepatitis E virus: from epidemiology to molecular biology. Viral Hepatitis Rev 3: 227–251Google Scholar
  55. Wirth S (1996) Chronische Hepatitis B, D und C im Kindesalter. Verdauungskrankheiten 14: 22–27Google Scholar
  56. Wirth S, Koletzko S (1994) Autoimmunhepatitis im Kindesalter. Monatsschr Kinderheilkd 142: 908–916Google Scholar
  57. Zuckerman AJ, Thomas HC (1993)Viral hepatitis. Churchill Livingstone, EdinburghGoogle Scholar
  58. Cetta F (1997) Recurrent hepatolithiasis after primary excision of choledochal cysts. J Am Coll Surg 185: 198–200PubMedCrossRefGoogle Scholar
  59. Ishibashi T, Kasahara K,Yasuda Y, Nagai H, Makino S, Kanazawa K (1997) Malignant change in biliary tract after excision of choledochal cyst. Br J Surg 84: 1687–1691Google Scholar
  60. Miyano T, Yamataka A (1997) Choledochal cysts. Curr Opin Pediatr 9: 283–288PubMedCrossRefGoogle Scholar
  61. Okada A, Nakamura T, Higaki J, Okumura K, Kamata S, Oguchi Y (1990) Congenital dilatation of the bile duct in loo instances and its relationship with anomalous junction. Surg Gynecol Obstet 171: 291–298PubMedGoogle Scholar
  62. Saing H, Han H, Chan KL, Lam W, Chan FL, Cheng W, Tam PK (1997) Early and late results of excision of choledochal cysts. J Pediatr Surg 32: 1563–1566PubMedCrossRefGoogle Scholar
  63. Sela-Herman S, Scharschmidt BF (1996) Choledochal cyst, a disease for all ages. Lancet 23: 779CrossRefGoogle Scholar
  64. Tanaka T (1995) Pathogenesis of choledochal cyst. Am J Gastroenterol 90: 685PubMedGoogle Scholar
  65. Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K (1977): Congenital bile duct cysts: classification, operative procedures and review of 37 cases including cancer arising from choledochal cysts. Am J Surg 134: 263–269PubMedCrossRefGoogle Scholar
  66. Todani T, Urushihara N, Morotomi Y et al. (1995) Characteristics of choledochal cysts in neonates and early infants. Eur J Pediatr Surg 5: 143–145PubMedCrossRefGoogle Scholar
  67. Yamaguchi M (1980) Congenital choledochal cyst: analysis of 1,433 patients in the Japanese literature. Am J Surg 140: 653–657PubMedCrossRefGoogle Scholar
  68. A-Kader HH, Heubi JE, Setchell KDR, Ryckman FC, Balistreri WF (1990) The effect of ursodeoxycholic adic therapy in patients with extrahepatic biliary atresia. Gastroenterology 98: A564Google Scholar
  69. Broelsch CE, Whitington PF, Edmond JC (1991) Liver transplantation in children from living related donors. Ann Surg 214: 428–439PubMedCrossRefGoogle Scholar
  70. Choi SO, Park WH, Lee HJ (1998) Ultrasonographic triangular cord: the most definitive finding for noninvasive diagnosis of extrahepatic biliary atresia. Eur J Pediatr Surg 8: 12–16PubMedCrossRefGoogle Scholar
  71. Davenport M, Kerkar N, Mieli-Vergani G, Mowat AP, Howard ER (1997) Biliary atresia: the King’s College Hospital experience (1974–1995). 1 Pediatr Surg 32: 479–485Google Scholar
  72. Desmet FJ (1992) Congenital diseases of intrahepatic bile ducts: variation on the theme “ductal plate malformation”. Hepatology 16: 1069–1083PubMedCrossRefGoogle Scholar
  73. Desmet FJ, Callea F (1990) Cholestatic syndromes in infancy and childhood. In: Zakim D, Boyer TD (eds) Hepatology. A textbook of liver disease, 2nd edn, vol 2. Saunders, Philadelphia, pp 1355–1395Google Scholar
  74. Karrer FM, Lilly JR, Steward BA, Hall RJ (1990) Biliary atresia registry, 1976–1989. J Pediatr Surg 25: 1076–1081PubMedCrossRefGoogle Scholar
  75. Karrer FM, Price M, Bensard D, Sokol R, Narkewicz M, Smith D, Lilly JR (1996) Long term results with the Kasai operation for biliary atresia. Arch Surg 131: 493–496PubMedCrossRefGoogle Scholar
  76. Kasai M, Suzuki S (1959) A new operation for non-correctable biliary atresia: hepatic portoenterostomy. Shujitsu 13: 733–739Google Scholar
  77. Landing BH (1974) Considerations of the pathogenesis of neonatal hepatitis, biliary atresia and choledochal cyst–the concept of infantile obstructive cholangiopathy. Prog Pediatr Surg 6: 113–139PubMedGoogle Scholar
  78. Lin WY, Lin CC, Changlai SP, Shen YY, Wang SJ (1997) Comparison of Tc-99 m disofenin cholescintigraphy with ultrasonography in the differentiation of biliary atresia from other forms of neonatal jaundice. Pediatr Surg Int 12: 30–33PubMedCrossRefGoogle Scholar
  79. Mieli-Vergani G, Howard ER, Portman B, Mowat AP (1989) Late referral for biliary atresia–missed opportunities for effective surgery. Lancet 1: 421–423PubMedCrossRefGoogle Scholar
  80. Otte JB, Vries-Hospens HG de, Sokal E (1990) Size reduction of the donor liver is a safe way to alleviate the shortage of size matched organs in pediatric liver transplantation. Ann Surg 211: 146–157PubMedCrossRefGoogle Scholar
  81. Stein JE, Vacanti JP (1994) Biliary atresia and other disorders of the extrahepatic biliary tree. In: Suchy FJ (ed) Liver diseases in children. Mosby Year Book, St. Louis, MissouriGoogle Scholar
  82. Cahalane MJ, Neubrand MW, Carey MC (1988) Physical chemical pathogenesis of pigment stones. Semin Liver Dis 8: 317–328PubMedCrossRefGoogle Scholar
  83. Heubi JE, Lewis LG (1994) Diseases of the gallbladder in infancy, childhood and adolescence. In Suchy FJ (ed) Liver disease in children. Mosby Year Book, St. Louis, pp 605–621Google Scholar
  84. Kim P, Wesson D, Superina R, Filler R (1995) Laparoscopic cholecystectomy versus open cholecystectomy in children. Which is better? J Pediatr Surg 30: 971–973PubMedCrossRefGoogle Scholar
  85. Palasciano G, Portincasa P, Vinciguerra V et al. (1989) Gallstone prevalence and gallbladder volume in children and adolescents: an epidemiological ultrasonographic survey and relationship to body mass index. Am J Gastroenterol 84: 1378–1382PubMedGoogle Scholar
  86. Reif S, Sloven DG, Lebenthal E (1991) Gallstones in children. AJDC 145: 105–108PubMedGoogle Scholar
  87. Asselah T, Ernst O, Sergent G, L’Hermine C, Paris JC (1998) A magnetic resonance cholangiopancreatography diagnosis. Am J Gastroenterol 93: 109–110PubMedCrossRefGoogle Scholar
  88. Caroli J, Corcos V(1964) La dilatation congenitale de voies biliaires intrahepatiques. Rev Med Chir Mal du Foie 39: 1–70Google Scholar
  89. Dagli U, Atalay F, Sasmaz N, Bostanoglu S, Temucin G, Sahin B (1998) Caroli’s disease: 1977–1995 experience. Eur J Gastroenterol Hepatol 10: 109–112PubMedCrossRefGoogle Scholar
  90. Gold DM, Stark B, Pettei MJ, Levine JJ (1995) Successful use of an internal biliary stent in Caroli’s disease. Gastrointest Endosc 42: 589–592PubMedCrossRefGoogle Scholar
  91. Keane F, Hadzic N, Wilkinson ML, Qureshi S, Reid C, Baker AJ, MieliVergani G (1997) Neonatal presentation of Caroli’s disease. Arch Dis Child 77: F145 - F146CrossRefGoogle Scholar
  92. Pinto RB, Lima JP, Silveira TR da, Scholl JG, Mello ED de, Silva G (1998) Caroli’s disease: report of 10 cases in children and adolescents in Southern Brazil. J Pediatr Surg 33: 1531–1535PubMedCrossRefGoogle Scholar
  93. Sans M, Rimola A, Navasa M et al. (1997) Liver transplantation in patients with Caroli’s disease and recurrent cholangitis. Transpl Int 10: 241–244PubMedGoogle Scholar
  94. Taylor ACF, Palmer KR (1998) Caroli’s disease. Eur J Gastroenterol Hepatol 10: 105–108PubMedCrossRefGoogle Scholar
  95. Torra R, Badenas C, Darnell A, Bru C, Escorsell A, Estivill X (1997) Autosomal dominant polycystic kidney disease with anticipation and Caroli’s disease associated with a PKDi mutation: rapid communication. Kidney Int 52: 33–38PubMedCrossRefGoogle Scholar
  96. Bernuau J, Samuel D, Durand F (1991) Criteria for emergency liver transplantation in patients with acute viral hepatitis and factor V (FV) below 5o% of normal: a prospective study. Hepatology 14: 49Google Scholar
  97. Lindstedt S, Holme E, Lock EA, Hjalmarson O, Strandvik B (1992) Treatment of hereditary tyrosinaemia type I by inhibition of 4-hydroxyphenylpyruvate dioxygenase. Lancet 340: 813–817PubMedCrossRefGoogle Scholar
  98. Melter M, Rodeck B, Brodehl J (1996) Akutes Leberversagen im Kindesalter. Monatsschr Kinderheilkd 144: 592–598Google Scholar
  99. Mowat AP (1994) Fulminant and severe acute liver failure. In: Mowat AP (ed) Liver disorders in childhood. Butterworth-Heinemann, Oxford, pp 151–166Google Scholar
  100. Müller T, Feichtinger H, Berger H, Müller W (1996) Endemic Tyrolean infantile cirrhosis: an ecogenetic disorder. Lancet 347: 877–880PubMedCrossRefGoogle Scholar
  101. O’Grady JG,Williams R (1986) Management of acute liver failure. Schweiz Med Wochenschr 26: 541–544Google Scholar
  102. O’Grady JG, Alexander GJ, Hayllar KM, Williams R (1989) Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 97: 439–445PubMedGoogle Scholar
  103. Pfister ED, Melter M, Rodeck B et al. (1998) Prädiktive Faktoren bei akutem Leberversagen im Kindesalter. Monatsschr Kinderheilkd 146: 98Google Scholar
  104. Sokol RJ (1998) Fulminant hepatic failure. In: Balistreri WF, Stocker JT (eds) Pediatric hepatology. Hemisphere, New York, pp 315–362Google Scholar
  105. Whitington PF (1994) Fulminant hepatic failure in children. In: Suchy FJ (edg) Liver disease in children. Mosby, St. Louis, pp 180–213Google Scholar
  106. Bismuth H, Houssin D (1984) Reduced-sized orthotopic liver graft in hepatic transplantation in children. Surgery 95: 367–370PubMedGoogle Scholar
  107. Broelsch CE, Emond JC, Whitington PF, Thistlethwaite JR, Baker AL, Lichtor IL (1990) Application of reduced-size liver transplants as split grafts, auxiliary orthotopic grafts, and living related segmental transplants. Ann Surg 212: 368–375PubMedCrossRefGoogle Scholar
  108. Lee H, Vacanti JP (1996) Liver transplantation and its long-term management in children. Pediatr Clin North Am 43: 99–124PubMedCrossRefGoogle Scholar
  109. Martinez Ibanez V, Boix Ochoa J, Lloret J, Broto J (1992) Paediatric liver transplantation: life after portoenterostomy in biliary atresia. J Pediatr Surg 27: 830–832PubMedCrossRefGoogle Scholar
  110. McDiarmid SV, Busuttil RW, Ascher NL et al. (1995) FK506 (tacrolimus) compared with cyclosporine for primary immunosuppression after pediatric liver transplantation. Results from the U. S. Multicenter Trial. Transplantation 59: 530–536Google Scholar
  111. Pichlmayr R, Ringe B, Gubernatis G, Hauss J, Bunzendahl H (1988) Transplantation einer Spenderleber auf zwei Empfänger ( Splitting Transplantation) - eine neue Methode in der Weiterentwicklung der Lebersegmenttransplantation. Langenbecks Arch Chir 373: 127–130Google Scholar
  112. Pruim J, Klompmaker IJ, Haagsma EB, Bijleveld CMA, Slooff MJH (1993) Selection criteria for liver donation: a review. Transpl Int 6: 226–235PubMedCrossRefGoogle Scholar
  113. Ryckman FC, Ziegler MM, Pedersen SH et al. (1994) Liver transplantation in children. In: Suchy FJ (ed) Liver disease in children. Mosby, St. Louis, pp 930–950Google Scholar
  114. Rodeck B, Melter M, Kardorff R et al. (1996) Liver transplantation in children with chronic end stage liver disease: factors influencing survival after transplantation. Transplantation 62: 1071–1076PubMedCrossRefGoogle Scholar
  115. Rodeck B, Melter M, Kardorff R et al. (1996) Lebertransplantation im Kindesalter. Monatsschr Kinderheilkd 144: 490–495Google Scholar
  116. Gentil-Kocher S, Bernard O, Brunelle F et al. (1988) Budd-Chiari syndrome in children: report of 22 cases. J Pediatr 113: 30–38PubMedCrossRefGoogle Scholar
  117. Ludwig J, Hashimoto E, McGill DB et al. (1990) Classification of hepatic venous outflow obstruction: ambiguous terminology of the Budd-Chiari syndrome. Mayo Clin Proc 65: 51–55PubMedCrossRefGoogle Scholar
  118. McDonald GB, Sharma P, Mattews DE et al. (1984) Veno-occlusive disease of the liver after bone marrow transplantation: diagnosis, incidence and predisposing factors. Hepatology 4: 116–122PubMedCrossRefGoogle Scholar
  119. Rössle M, Siegerstetter V, Huber M et al. (1998) The first decade of the transjugular intrahepatic portosystemic shunt (TIPS): state of the art. Liver 18: 73–89PubMedGoogle Scholar
  120. Alvarez F, Bernard O, Brunelle F, Hadchouel P, Odievre M, Alagille D (1983) Portal obstruction in children. I. Clinical investigation and hemorrhage risk. II. Results of surgical portosystemic shunts. J Pediatr 103: 696–707Google Scholar
  121. D’Amico G, Pagliaro L, Bosch J (1995) The treatment of portal hypertension: a meta-analytic review. Hepatology 22: 332–354PubMedGoogle Scholar
  122. Evans S, Strovroff M, Heiss K, Ricketts R (1995) Selective distal splenorenal shunts for intractable variceal bleeding in pediatric portal hypertension. J Pediatr Surg 30: 1115–1118PubMedCrossRefGoogle Scholar
  123. Heyman MB, LaBerge JM, Somberg KA, Rosenthal P, Mudge C, Ring EJ, Snyder JD (1997) Transjugular intrahepatic portosystemic shunts ( TIPS) in children. J Pediatr 131: 914–919Google Scholar
  124. Hirner A, Wolff M (1996) Portosystemische Shunt-Chirurgie wegen Osophagusvarizenblutung. Dtsch Ärzteblatt 93 /14: C636 - C641Google Scholar
  125. Maksoud JG, Goncalves MEP, Porta G, Miura I, Velhote MCP (1991) The endoscopic and surgical management of portal hypertension in children: analysis of 123 cases. J Pediatr Surg 26: 178–181PubMedCrossRefGoogle Scholar
  126. Mowat AP (1994) Liver disorders in childhood, 3rd edn. Butterworth-Heinemann, OxfordGoogle Scholar
  127. Nolte W, Hartmann H, Ramadori G (1994) Portale Hypertension-Patho- physiologie und Therapieansätze. Z Gastroenterol 32: 447–459PubMedGoogle Scholar
  128. Price MR, Sartorelli KH, Karrer FM, Narkewicz MR, Sokol RJ, Lilly JR (1996) Management of esophageal varices in children by endoscopic varical ligation. J Pediatr Surg 31: 1056–1059PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • M. Becker
  • M. Burdelski
  • D. Feist
  • K. Pittschieler
  • S. Wirth
  • T. Lang
  • J. Deutsch
  • B. Rodeck
  • M. Melter
  • A. Ballauff

There are no affiliations available

Personalised recommendations