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Fulminant hepatic failure in children: etiology, histopathology and MDCT findings

Banu Cakir1, Ismail Kirbas, Beyhan Demirhan

  • 1Baskent University Faculty of Medicine Department of Radiology, Fevzi Cakmak Cd. 10, Sok. No: 45, Bahcelievler, Ankara, Turkey. banutopcu@yahoo.com

European Journal of Radiology
|September 6, 2008
PubMed

Insights

This study identified causes of pediatric fulminant hepatic failure, finding diffuse hepatic attenuation and ascites on MDCT scans. Massive hepatic necrosis was the most common biopsy finding in these critical liver cases.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Radiology

Background:

  • Fulminant hepatic failure (FHF) in children is a critical condition with diverse etiologies.
  • Accurate diagnosis relies on understanding causative agents, histopathology, and imaging findings.

Purpose of the Study:

  • To determine the etiologies of FHF in children.
  • To correlate histopathologic findings with MDCT (multi-detector computed tomography) in pediatric FHF.
  • To identify common MDCT findings in children with FHF.

Main Methods:

  • Retrospective analysis of 15 children with FHF who underwent MDCT between June 2004 and November 2006.
  • Classification of patients into hyperacute, acute, and subacute groups based on hepatic encephalopathy onset.
  • Correlation of MDCT findings with histopathologic results from 12 liver biopsies.

Main Results:

  • Identified etiologies included Hepatitis A, non-A, non-E hepatitis, mushroom poisoning, Wilson's disease, and autoimmune hepatitis.
  • Common MDCT findings: diffuse hepatic attenuation reduction (11/15), ascites (9/15), periportal edema (6/15), and gallbladder wall edema (6/15).
  • Histopathology revealed massive hepatic necrosis (8/12) as the most frequent finding, alongside inflammatory changes and regenerative nodules.

Conclusions:

  • Diffuse reduction in hepatic attenuation and ascites are the most frequent MDCT findings in pediatric FHF.
  • Massive hepatic necrosis is the predominant histopathologic characteristic of FHF in children.
  • MDCT and liver biopsy are crucial for diagnosing and understanding FHF in pediatric patients.
Abstract

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