Cirrhosis of the liver
The first step in treating your child is forming an accurate and complete diagnosis. Your child’s doctor will usually make a diagnosis of cirrhosis based on a combination of symptoms, medical history, physical exam, and blood tests.
In most cases, our doctors will order a liver biopsy to confirm the diagnosis, and help them see the extent of the scarring in your child’s liver.
Your doctor may gauge the severity of your child’s cirrhosis using a system called the CTP or Child-Turcotte-Pugh (“Child”) score. This score combines a set of three laboratory-based measures (bilirubin, albumin, and prothrombin time) with two bedside ones (the presence and severity of ascites, and the level of encephalopathy). While this scoring system was designed for adults and has its limitations, it draws a good picture of both the status of your child’s liver and the overall changes in the body caused by cirrhosis.
Regardless of the underlying cause, once they make a diagnosis of cirrhosis our doctors will keep track of your child’s condition by several means, including periodic:
- Blood tests, to check how well your child’s liver is working as well as his or her fluid balance.
- Ultrasounds, which use high frequency sound to help your child’s doctor to see his or her liver. Ultrasounds are painless, non-invasive, and use no radiation.
- Physical exams.
In addition, our doctors will want to check your child’s blood oxygen levels every year to see whether he or she is developing hepatopulmonary syndrome, in which increased blood pressure in the liver’s portal vein causes changes in how blood circulates through the lungs. We will also monitor your child’s kidneys for signs of complications.
Our doctors may also want to occasionally conduct an endoscopic exam to see whether new, weakened blood vessels called varices are growing in your child’s esophagus in response to the irregular blood flow in the liver. To do this, they will either use either an endoscope – a small, flexible tube – to examine the inside of your child’s esophagus, or ask him or her to swallow a small capsule containing a camera, which will pass through your child’s digestive tract.
Because cirrhosis can raise your child’s risk of developing liver cancer, our doctors will want to conduct regular cancer surveillance.