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    Clinical Approach To Neonatal Jaundice: Dr. Siddeeg Addow Pediatric Resident Khartoum, Sudan

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    Isak Isak Isak
    This document provides an overview of neonatal jaundice, including: 1. It discusses the pathophysiology of jaundice, explaining how bilirubin is produced and cleared from the body normally, and how disturbances can lead to jaundice. 2. It outlines the differential diagnosis for neonatal jaundice, including causes related to excessive bilirubin production, reduced hepatic uptake or conjugation, decreased excretion, or decreased bile flow. 3. It describes the clinical approach for evaluating a jaundiced neonate, including taking a history, performing an examination, and selecting appropriate investigations to determine the underlying cause.

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    Clinical Approach To Neonatal Jaundice: Dr. Siddeeg Addow Pediatric Resident Khartoum, Sudan

    Uploaded by

    Isak Isak Isak
    53 views17 pages
    This document provides an overview of neonatal jaundice, including: 1. It discusses the pathophysiology of jaundice, explaining how bilirubin is produced and cleared from the body normally, and how disturbances can lead to jaundice. 2. It outlines the differential diagnosis for neonatal jaundice, including causes related to excessive bilirubin production, reduced hepatic uptake or conjugation, decreased excretion, or decreased bile flow. 3. It describes the clinical approach for evaluating a jaundiced neonate, including taking a history, performing an examination, and selecting appropriate investigations to determine the underlying cause.

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    This document provides an overview of neonatal jaundice, including: 1. It discusses the pathophysiology of jaundice, explaining how bilirubin is produced and cleared from the body normally, and how disturbances can lead to jaundice. 2. It outlines the differential diagnosis for neonatal jaundice, including causes related to excessive bilirubin production, reduced hepatic uptake or conjugation, decreased excretion, or decreased bile flow. 3. It describes the clinical approach for evaluating a jaundiced neonate, including taking a history, performing an examination, and selecting appropriate investigations to determine the underlying cause.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    53 views17 pages

    Clinical Approach To Neonatal Jaundice: Dr. Siddeeg Addow Pediatric Resident Khartoum, Sudan

    Uploaded by

    Isak Isak Isak
    This document provides an overview of neonatal jaundice, including: 1. It discusses the pathophysiology of jaundice, explaining how bilirubin is produced and cleared from the body normally, and how disturbances can lead to jaundice. 2. It outlines the differential diagnosis for neonatal jaundice, including causes related to excessive bilirubin production, reduced hepatic uptake or conjugation, decreased excretion, or decreased bile flow. 3. It describes the clinical approach for evaluating a jaundiced neonate, including taking a history, performing an examination, and selecting appropriate investigations to determine the underlying cause.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 17

    Clinical Approach to

    Neonatal Jaundice

    Dr. Siddeeg Addow


    Pediatric Resident
    Khartoum, Sudan
    :CONTENTS

    INTRODUCTION
    PATHOPHYSIOLOGY
    DIFFERENTIAL DIAGNOSIS
    HISTORY
    EXAMINATION
    INVESTIGATION
    INTRODUCTION
    Bilirubin is the end product of heme
    degradation
    Most of the daily production comes
    from the breakdown of RBCs in the RES
    Heme biliverdin
    bilirubin
    Bilirubin is released & bound to serum
    albumin
    Bilirubin is uptake & conjugated with
    glucuronic acid
    Finally conjugated bilirubin is excreted
    in bile
    PATHOPHYSIOLOGY
    UNCONJUGATED B. CONJUGATED B.
    Tightly Non toxic
    compounded to s.
    albumin Water soluble
    Normally very small Loosely bound to
    amount is present albumin. Delta
    as albumin free fraction
    Insoluble in water
    can not be excreted
    in urine
    Toxic
    Both conjugated & unconjugated
    bilirubin may accumulate
    systemically & deposit in tissues
    Normally s. bilirubin level vary
    b/w 0.3 & 1.2mg/dl.
    The rate of systemic bilirubin
    production is = to the rate of
    hepatic uptake, conjugation &
    biliray excretion .
    Jaundice becomes evident when
    the s.bilirubin levels rise above
    2.0 to 2.5mg/dl
    Levels as high as 30 to 40mg/dl
    can occur with sever disease
    Jaundice occurs when the = b/w
    bilirubin production &clearance
    is disturbed by one or more of
    the following mechanisms:
    1.Excessive production of bilirubin
    2.Reduced hepatic uptake
    3.Impaired conjugation
    4.Decreased hepatocellular
    excretion
    5.Impaired bile flow
    CAUSES OF JAUNDICE
    Excessive production of
    bilirubin

    hemolytic anemia's
    resorption of blood from
    internal hemor.
    ineffective erythropoiesis
    Reduced hepatic
    uptake:

    drugs
    some cases of Gilbert
    syndrome
    Impaired bilirubin
    conjugation:

    physiologic jaundice
    breast milk jaundice
    genetic deficiency of glcuronosyl
    transferase
    decreased expression of
    glcuronosyl transferase
    diffuse hepatocellular diseases
    Decrease excretion of
    conjugated bilirubin:
    deficiency in canalicular
    membrane transport
    drug induced canalicular
    membrane dysfunction
    hepatocelluler damage or
    toxicity
    Decreased intrahepatic
    bile flow :

    inflammatory
    destruction of
    intrahepatic bile ducts
    Extra hepatic biliary
    obstruction:

    gall stone obstruction of biliary


    tree
    extra hepatic biliary atresia
    biliary stricture & choledochal
    cyst
    primary sclerosing cholangitis
    liver fluke infestation
    carcinoma
    HISTORY
    onset / duration
    pain
    nausea & vomiting
    loss of weight
    itching
    color of stool
    color of urine
    past history
    ttt &family history
    EXAMINATION
    color of skin
    severity of jaundice
    anemia
    liver
    spleen
    gall bladder
    ascites
    INVESIGATION
    CBC
    LFT
    Prothrombin time
    Alfa feto proteins
    UG
    SG
    U/S
    ERCP & PTC
    Liver biopsy
    The End

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