Title |
Ascites in Children
|
---|---|
Published in |
Journal of Pediatric Gastroenterology & Nutrition, January 2017
|
DOI | 10.1097/mpg.0000000000001209 |
Pubmed ID | |
Authors |
Wikrom Karnsakul, Thammasin Ingviya, Eric Seaberg, Pavis Laengvejkal, Hejab Imteyaz, Alexandra Vasilescu, Kathleen B. Schwarz, Ann O. Scheimann |
Abstract |
The aim of our study was to describe the changing prevalence, demographic features, etiologies, and treatment of ascites in children hospitalized over a 27 year period at the Johns Hopkins Hospital. We retrospectively reviewed discharges from 1983-2010 to select patients whose records included a diagnosis of ascites. We assessed the etiologies and degrees of ascites (ascites grade 1 detectable only by radiologic tests; ascites grade 2&3 recognized by moderate and marked abdominal distension by physical examinations). We classified 518 children into 9 etiology groups: 105 had intrahepatic disease (IH), hepatic vein outflow obstruction (HVOO) (45), congestive heart disease (CH) (33), nephrotic syndrome (NS) (36), pancreatitis (26), inflammatory & infectious diseases (77), malignancy (49), idiopathic (71), and miscellaneous (76). IH and CH were predominant in younger age group (0-5 years) vs HVOO, pancreatitis and malignancy in the older age group (13-21 years) (p < 0.001). The prevalence of ascites increased over time from 1983-2006 and declined thereafter. Ascites grade 1 was more common than ascites grade 2&3 in all groups, (p = 0.048). IH and NS were more likely to have ascites grade 2&3 (p = 0.02). While spironolactone was more frequently used in IH group vs other etiologies, furosemide was used more frequently in NS and CH vs other etiologies (p < 0.001). The increased prevalence of ascites over the initial study period could reflect improved detection radiologic detection. The proportion of severe ascites and the various medical treatments differed among the etiologic groups. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 26 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 4 | 15% |
Student > Bachelor | 3 | 12% |
Other | 2 | 8% |
Student > Master | 2 | 8% |
Student > Ph. D. Student | 2 | 8% |
Other | 3 | 12% |
Unknown | 10 | 38% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 14 | 54% |
Environmental Science | 1 | 4% |
Unknown | 11 | 42% |