[Prolonged icterus as a difficult diagnostic problem in small children--own observations].

UNLABELLED: THE AIM of the study was the retrospective evaluation of causes of prolonged icterus in children treated in the Second Department of Peadiatrics and Allergology in Łódź during the last 16 years.

MATERIAL AND METHODS: 361 children aged 3 weeks to 15 months of 12650 patients hospitalised in our Clinic were analysed. All the examined children were divided into two groups group I consisted of 314 children with unconjugated hyperbilirubinemia and group II of 47 patients with cholestasis Additionally the cholestatic group was divided into two subgroups: IIa consisted of 41 children with intrahepatic cholestasis and IIb--six children with extrahepatic cholestasis.

RESULTS: The most common reasons of icterus in groups I and IIa were respiratory tract infections and cytomegalovirus infections All of these children recovered. Metabolic diseases were diagnosed in 4 children (galactosemia, fructosemia and in two children mucoviscidosis) in 5 children other genetic syndromes (Crigler-Najjar, Allagille and in three Byler disease). Six children from group IIb with extrahepatic biliary atresia were transferred to the Department of Paediatric Surgery. All of them underwent Kasai operation.

CONCLUSIONS: Small children's prolonged icterus needs immediate and intense investigations to set as fast as possible the correct diagnosis of its cause. Early diagnosis of its cause increases the prospect of effective treatment and prevents the child from potential development of hepatic failure.