Practical Approach to Pediatric Gastroenterology, Hepatology and Nutrition

275 Pages·2013·10.04 MB·English

Practical Approach to
Paediatric
Gastroenterology,
Hepatology and
Nutrition

Practical Approach to
Paediatric
Gastroenterology,
Hepatology and
Nutrition
Deirdre Kelly, MD, FRCP, FRCPI, FRCPH
The Liver Unit
Birmingham Children’s Hospital;
Professor of Paediatric Hepatology
University of Birmingham
Birmingham, UK
Ronald Bremner, DM, FRCPCH
Consultant Paediatric Gastroenterologist
Department of Gastroenterology and Nutrition
Birmingham Children’s Hospital
Birmingham, UK
Jane Hartley, MBChB, MRCPCH, MMedSc, PhD
Consultant in Paediatric Hepatology and Small Bowel Transplantation
The Liver Unit
Birmingham Children’s Hospital
Birmingham, UK
Diana Flynn, MBBCh, MRCPCH, BSc, PhD
Consultant Paediatric Gastroenterologist
Department of Gastroenterology
Royal Hospital for Sick Children
Glasgow, UK
This edition first published 2014 © 2014 by John Wiley & Sons, Ltd.
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Library of Congress Cataloging-in-Publication Data
Bremner, Ronald, author.
Practical approach to paediatric gastroenterology, hepatology, and nutrition /
Ronald Bremner, Jane Hartley, Diana Flynn ; editor, Deirdre Kelly.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-470-67314-0 (pbk. : alk. paper) – ISBN 978-1-118-77866-1 (epdf) –
ISBN 978-1-118-77882-1 (epub) – ISBN 978-1-118-77883-8 (emobi)
I. Hartley, Jane, author. II. Flynn, Diana, author. III. Kelly, Deirdre A., editor. IV. Title.
[DNLM: 1. Gastrointestinal Diseases–Handbooks. 2. Child Nutrition Disorders–
Handbooks. 3. Child. 4. Infant Nutrition Disorders–Handbooks. 5. Infant. 6. Liver
Diseases–Handbooks. WS 39]
RJ446
618.92'33–dc23
2013024997
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears
in print may not be available in electronic books.
Cover image: iStock File #7646055 © Fertnig
Set in 9/12 pt Palatino by Toppan Best-set Premedia Limited
1 2014
Contents
Preface, vii
Acknowledgements, viii
Part I Gastroenterology, 1
1 The infant with abdominal pain, 3
2 The child with abdominal pain, 6
3 The infant with vomiting, 15
4 The child with vomiting, 21
5 Difficulty swallowing, 24
6 Abdominal distension, 29
7 The infant with acute diarrhoea, 32
8 The child with acute diarrhoea, 35
9 The infant with chronic diarrhoea, 40
10 The child with chronic diarrhoea, 47
11 Gastrointestinal bleeding, 61
12 Food-associated symptoms, 67
13 Abdominal mass, 76
14 The infant with constipation, 79
15 The child with constipation, 83
16 Perianal pain, 90
Part II Hepatology, 93
17 The infant with jaundice, 95
18 The acutely unwell infant, 108
19 The infant with splenomegaly, 118
20 The infant with a hepatic cause for abdominal distension, 121
21 The older child with jaundice, 128
22 The older child who is acutely unwell, 134
23 The older child with hepatic causes of abdominal distension, 138
24 Chronic liver disease: itching, 141
25 Chronic liver disease: ascites, 145
26 Chronic liver disease: haematemesis or meleana, 148
v
vi | Contents
27 Children with incidental abnormal liver biochemistry, 150
28 The child with cystic fibrosis, 152
29 The child with liver disease following chemotherapy, 155
30 The management of a child with acute liver failure, 158
31 Indications for liver transplant, 164
32 Complications following liver transplant, 166
Part III Nutrition, 171
33 Nutritional monitoring, 173
34 Nutrition in the normal infant: breast-feeding, 176
35 Nutrition in the normal infant: infant formulae, 180
36 Nutrition in premature infants, 183
37 Problems with weaning, 186
38 The infant or child with poor feeding, 188
39 Food aversion, 192
40 Ingestion of non-food items (pica), 194
41 Nutrition in neurodisability, 198
42 Malnutrition, 201
43 Obesity, 209
44 Intestinal failure, 213
45 Parenteral nutrition: initiating and monitoring, 225
46 Parenteral nutrition: complications, 230
47 Parenteral nutrition: weaning, 237
48 Home parenteral nutrition, 239
49 Enteral tube feeding, 241
50 Nutrition in cystic fibrosis, 247
Index, 249
Preface
Paediatrics is a rapidly evolving field of medicine, particularly in the
sub-specialties. This makes it difficult for trainees, junior doctors and
allied health professionals to keep up with new developments.
This book aims to provide problem-orientated clinical scenarios in
paediatric gastroenterology, hepatology and nutrition, and is designed
to make initial assessment, management and referral of children easy to
follow.
The book is up to date with current practice, user friendly, with links
to the latest guidance, protocols and information, and should be a
popular book no trainee doctor should be without.
We hope you enjoy using it and that it will help you improve how you
manage children with these specialist conditions.
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