CHOLESTASIS IN INFANT : A STUDY OF THE CHILDREN’S HOSPITAL OF TUNIS

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Vol. 86 No. 2 (2008): Issue Feb 2008

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Olfa Bouyahia
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie
Ibtissem Khelifi
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie
Sonia Mrad Mazigh
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie
Lamia Gharsallah
Service de Médecine Infantile C à Hôpital d'Enfants de Tunis -Jebbari Bab Saadoun- Tunis
Beji Chaouachi
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie
Mourad Hamzaoui
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie
Sihem Barsaoui
Service Médecine Infantile A à Hôpital d'Enfants- Tunis
Sayda Ben Becher
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie
Souad Bousnina
Department of pediatrics B of the children's hospital of Tunis
Samir Boukthir
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie
Azza Sammoud El Gharbi
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie

Abstract

Background : Cholestasis in infant constitutes an heterogeneous group of disease; diagnosis and management are often difficult.
The Aim of the study is to describe clinical, paraclinical characteristics and outcome of infants hospitalized for cholestasis in children’s Hospital of Tunis.
Methods : A retrospective study of 94 infants with cholestasis was conducted. Patients were hospitalized in four departments of paediatrics of our hospital between January 1995 and December 2005. Cholestasis complicating severe sepsis and visceral leishmaniasis were excluded.
Results : Incidence of cholestasis was 8.5 cases/year which represented 0.72 % of the hospitalizations. Sex ratio was 1.08 and mean age at diagnosis was 105 days (extremes: 1day- 24 months). Biliary atresia was the most common cause of extra hepatic cholestasis (13.8%). Normal Á GT cholestasis (11.7 %), benign neonatal cholestasis (11.7 %) and bile duct hypoplasia (9.5%) represented the most common aetiologies of intra hepatic cholestasis. Aetiology remained unknown in 12.7% of cases. Only three infants with biliary atresia had Kasaï operation. After a mean follow-up of 6 years, 18 % of patients had portal hypertension, 14.8 % had hepatic failure and mortality rate was 14.8 %.
Conclusions : Cholestasis of unknown aetiologies are frequent in our hospital. Poor prognosis, in our study, is due to delay to diagnosis and difficulties in medical and surgical management.

Keywords:

Cholestasis, Biliary Cirrhosis, Liver transplantation, Child

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