Transcripts
DR. TARR:
The liver also is affected in
acute Hemolytic Uremic Syndrome. When one gets
liver enzymes during HUS you will frequently see
elevated enzymes suggesting some degree of liver
injury though, it's hard to know with cells
breaking up throughout the body exactly where
the enzymes are coming from.
Ultrasounds frequently show
sludge in the gall bladder, which is a bit of a
problem. The gall bladder is not terribly
necessary for your digestion, it's a reservoir
for bile, and if you don't eat for a few days
possibly caused by medication, possibly
because of the child being sick, sludge can
accumulate in the gall bladder. Sometimes, when
the gallbladder contracts and the sludge is sent
downstream, it can cause obstruction.
We could discourage overcalling
the significance of this observation if this
abnormality is discovered on an abdominal
ultrasound because frequently when a child starts
to eat again the sludge gets broken up, goes
downstream and there are no problems.
Usually sludge is not an
indication for removal of the gall bladder,
though I am aware of at least one case where
the gall bladder was dramatically distended. The
child was incredibly tender in the right upper
quadrant, and the child also appeared ill and
the gall bladder was removed and the diagnosis
was made of cholecystitis. But usually sludge
in the gall bladder will get better when the
child gets better.
