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Intracranial hemorrhage associated with vitamin K deficiency bleeding in biliary atresia patients: Focus on the long-term outcome.
MedLine Citation:
PMID:  22124309     Owner:  NLM     Status:  Publisher    
INTRODUCTION: The prophylactic oral administration of vitamin K to newborns has markedly reduced the incidence of vitamin K deficiency. However, intracranial hemorrhage (ICH) is still one of the complications found in biliary atresia (BA) patients, and is associated with vitamin K deficiency bleeding (VKDB). Therefore, we aimed to investigate the incidence, and long-term outcome of ICH in BA patients who previously received prophylactic vitamin K during the neonatal period. PATIENTS & METHODS: Eighty-eight consecutive infants with BA were treated and followed up at Kyushu University Hospital from 1979 to 2009. The clinical records and imaging study results were retrospectively reviewed in the BA infants who presented with ICH. RESULTS: ICH occurred in 7.95% of BA patients. The onset of ICH occurred at 47-76 days after birth, before the patients underwent surgery for BA (9-37 days after the onset of ICH). Coagulopathy was found upon admission in all cases with available data, and improved after intravenous administration of vitamin K. A craniotomy was required in 2 cases before the surgery for BA. During the 22-278 months of follow-up, some neurological sequelae persisted in 5 of 7 cases. Follow-up head CT scans showed a low density area (LDA) in the left hemisphere in 5 cases. CONCLUSION: Although vitamin K prophylaxis had been given during the neonatal period, ICH associated VKDB was still found in 7.95% of BA patients. Persistent neurological sequlae were found in 5 of 7 cases, with LDA in the left hemisphere.
Fatima Safira Alatas; Makoto Hayashida; Toshiharu Matsuura; Isamu Saeki; Yusuke Yanagi; Tomoaki Taguchi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-24
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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