Gallbladder Function and Hepatic Structural Changes in Children with Nonalcoholic Fatty Liver Disease
During the last decade, pediatric nonalcoholic liver disease has reached epidemic proportions, becoming one of the most frequent chronic liver diseases in the global child population. Purpose: to study the relationship of the functional state of the gallbladder with structural changes in the liver in children with nonalcoholic fatty liver disease. Materials and methods. We examined 34 children aged from 8 to 17 years old. Hepatic steatosis was determined using the FibroScan® 502 touch with controlled attenuation parameter (CAP). According to the results of transient elastometry and ultrasound of the abdomen with the gallbladder function study, patients were divided into 4 groups: the 1st group consisted of 7 patients with steatosis and hypofunction of gallbladder (20.5 %), group 2 included 6 patients with steatosis and gallbladder normofunction (17.65 %), group 3 consisted of 11 patients without hepatic steatosis with hypofunction of gallbladder (32.35 %), group 4 included 10 patients without hepatic steatosis with gallbladder normofunction (29.4 %). Results. The sonographic studies demonstrated children of the 1st group (steatosis with gallbladder hypokinesia) to have significantly larger sizes of liver lobes compared to group 4 (children without steatosis with gallbladder normofunction). Also, the stiffness of the liver parenchyma was highest in patients with hepatic steatosis and gallbladder hypokinesia. Discussion. The combination of hepatic steatosis and hypokinesia of the gallbladder in children is accompanied by a significant increase in liver size, increased stiffness of the liver parenchyma and increasing degree of steatosis. The data indicate the relationship of the gallbladder function and the liver structural changes.
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