Pediatric Gastrointestinal and Liver Disease

6th Edition - October 6, 2020
Authors: Robert Wyllie, Jeffrey S. Hyams, Marsha Kay
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 6 7 2 9 3 - 1

Now with full-color illustrations throughout, dozens of new review questions, and state-of-the-art coverage of this fast-changing area, Pediatric Gastrointestinal and Liver Diseas… Read more

Pediatric Gastrointestinal and Liver Disease

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Now with full-color illustrations throughout, dozens of new review questions, and state-of-the-art coverage of this fast-changing area, Pediatric Gastrointestinal and Liver Disease, 6th Edition, remains the leading text in the field. You’ll find definitive guidance on diagnosis and treatment from experienced editors Drs. Robert Wyllie, Jeffrey S. Hyams, and Marsha Kay, as well as globally renowned contributors who share their knowledge and expertise on complex issues.

Instructions for online access
Cover image
Title page
Table of Contents
Copyright
Dedication
Preface
Contributors
Section 1. Biologic Aspects of Gastrointestinal Function
1. Development of the Gastrointestinal Tract
Introduction
Early Development: Patterning the Gastrointestinal Tract
The Gastrointestinal Tract Develops Along FOUR Axes
Later Development and Postnatal Maturation of the Intestine
Conclusion and Future Perspectives
2. Basic Aspects of Digestion and Absorption
Introduction
Key Principles of Digestion and Absorption
The Digestion and Absorption of Carbohydrates
The Digestive And Absorption Of Proteins
The Digestive And Absorption Of Lipids
Unique Aspects of Digestion and Absorption in Infants
Digestion and Absorption of Vitamins and Minerals
Minerals and Trace Elements
3. Bile Acid Physiology and Alterations in the Enterohepatic Circulation
Introduction
Biosynthesis
Enterohepatic Circulation
Maturation of the Enterohepatic Circulation
Alterations in the Enterohepatic Circulation
Alteration of Primary Bile Acid Biosynthesis
Alteration of Hepatic Bile Acid Transport
Mechanism of Bile Acid–Induced Diarrhea
Summary
4. The Gut Microbiome in Pediatrics
Introduction
5. Gastrointestinal Mucosal Immunology and Mechanisms of Inflammation
The Components of gut Immune Responses
The Generation of Inflammation
Mechanisms That Prevent Inflammatory Reactions to gut Luminal Contents
Organization of the Mucosal Immune System
Components of the Mucosal Immune System
The Establishment and Maintenance of Oral Tolerance to Antigens and the Flora
Patterns of Inflammatory Response Within the Intestine
Conclusions
Section 2. Clinical Problems
6. Chronic Abdominal Pain of Childhood and Adolescence
Introduction
Pathophysiology
Evaluation
Management
Prognosis
Conclusion
7. Approach to the Child with a Functional Gastrointestinal Disorder
Biomedical Model
Biopsychosocial Model
Early Learning: Developmental Aspects of Functional Gastrointestinal Disorders
Effective Reassurance
Biomedical Versus Biopsychosocial Models
Treatment
Approach to the Child or Adolescent With Pain-Associated Disability Syndrome
What Should a Pediatric Gastroenterology Consultation Accomplish?
Pediatric Functional Gastrointestinal Disorders
Conclusion
8. Vomiting and Nausea
Vomiting Event
Clinical Aspects of Vomiting
Nausea
Specific Vomiting Disorders
9. Diarrhea
Definition and Epidemiology
Physiology of Stool Formation
Classification of Diarrhea
Pathophysiology of Secretory Diarrhea
Pathophysiology of Osmotic Diarrhea
Pathophysiology of Inflammatory Diarrhea
Evaluation of a Child with Diarrhea
Further Evaluation
Evaluation of a Child with Acute Diarrhea
Diagnostic Testing in a Child with Chronic Diarrhea
Differential Diagnosis
Malabsorptive Diarrheas (See Box 9.5)
Congenital Diarrheal Diseases
Chronic Inflammatory Diarrhea
Irritable Bowel Syndrome
Intestinal Failure (Short Bowel Syndrome)
Medication-Induced Diarrhea
Neurohormonal Causes of Diarrhea
Summary
10. Colic and Gastrointestinal Gas
Gastrointestinal Gas
Colic
Conclusions
11. Functional Constipation and Fecal Incontinence
Definitions
Epidemiology
Pathogenesis
Quality of Life
Clinical Evaluation and Diagnosis
Treatment for Constipation
Treatment of Fnrfi
Follow-Up and Prognosis
12. Failure to Thrive/Growth Faltering
What is Failure to Thrive?
Diagnosing Failure to Thrive
Pitfalls in Diagnosing Failure to Thrive
Importance of Early Identification of Failure to Thrive
Causes and Evaluation of Failure to Thrive
Behavioral Concerns
Laboratory Testing
Treatment of Failure to Thrive
13. Gastrointestinal Hemorrhage
Introduction
Definitions
Initial Interventions
Causes and Differential Diagnosis
Gastrointestinal Bleeding in Toddler and School Aged Children (Box 13.10)
Gastrointestinal Bleeding in Adolescents and Young Adults (See Box 13.10)
Summary
14. Obesity
Definitions
Epidemiology
Etiology and Pathogenesis
Assessment of the Child with Obesity
Treatment
Summary
15. Eating Disorders in Children and Adolescents
Updated Definitions: What did DSM-5 Actually Change?
Recognizing Eating Disorders in Children and Adolescents
How can you Tell? Predictive Factors for Eating Disorders
Taking a History
Medical Complications From a Restricted Energy Intake
Refeeding Syndrome: What it is and How to Prevent it
Medical Complications From Purging
Effects of Vomiting as a Means of Purging
Medical Complications of Bingeing
Prognosis: Bone, Brain, and Babies (or Future Fertility)
Prevention: How it can be Done Better
Conclusions
16. Jaundice: Unconjugated Hyperbilirubinemia
Bilirubin Metabolism
Assessment of Jaundice
Neonatal Jaundice
17. Ascites
Overview
Pathophysiology
Etiology
Diagnosis
Management
Complications
18. Caustic Ingestion and Foreign Bodies
Ingestion of Caustic Agents
Ingestion of Foreign Bodies
Acute Management of Foreign Bodies
Conclusion
Section 3. The Esophagus
19. Developmental Anatomy and Physiology of the Esophagus
Developmental Anatomy of the Foregut/Esophagus
Genetic and Molecular Aspects of Tracheoesophageal Development
Anatomy of the Esophagus
Physiology of the Esophagus
Fetal and Neonatal Swallowing
Swallowing in the Normal Infant and Child
Summary
20. Congenital Malformations of the Esophagus
Congenital Lesions of the Esophagus
congenital esophageal stenosis
Esophageal Atresia and Tracheoesophageal Fistula
Laryngotracheoesophageal Clefts
21. Gastroesophageal Reflux
Abbreviations
Introduction
Definitions
Prevalence and Environmental/Genetic Factors
Pathophysiology
Symptoms and Signs
22. Achalasia and Other Motor Disorders
Disorders of the Proximal Esophagus
Disorders of the Distal Esophagus
New Treatments
23. Other Diseases of the Esophagus
Esophageal Symptoms
Infections
Other Inflammatory Causes of “Esophageal Symptoms”
Esophageal Tumors
Section 4. The Stomach
24. Developmental Anatomy and Physiology of the Stomach
Histology
Neuromuscular Functions
Gastric Secretions
Gastric Acid Secretion
Pepsinogen
Mucus and Bicarbonate Secretion
Gastric Lipase
Intrinsic Factor
25. Congenital Anomalies and Surgical Disorders of the Stomach
Embryology
Hypertrophic Pyloric Stenosis
Foveolar Hyperplasia
Congenital Gastric Outlet Obstruction
Gastric Volvulus
Congenital Microgastria
Gastric Perforation
Gastric and Duodenal Duplications
Polyps
Tumors
Gastric Foreign Bodies
26. Gastritis, Gastropathy, and Ulcer Disease
Incidence
Clinical Presentation
Diagnostic Testing
Etiology and Types of Gastritis, Gastropathies, and Ulcer Disease
Medications
Vascular Gastropathies
27. Helicobacter pylori in Childhood
Epidemiology
Host Factors and Responses
Bacterial Factors and Adaptations
Disease Associations
Diagnosis
Treatment
Conclusion
28. Gastric Motility Disorders
Introduction
Physiology of Gastric Motility and Sensation
Evaluation of Gastric Motility and Sensation
Gastroparesis
Functional Dyspepsia
Rumination Syndrome
Dumping Syndrome
Conclusion
29. Bezoars
Definitions
Epidemiology
Classification and Pathogenesis
Clinical Presentation
Diagnosis
Treatment
Prevention
Section 5. The Small and Large Intestine
30. Anatomy and Physiology of the Small and Large Intestines
Intestinal Anatomy
Physiology of Water and ion Transport
31. Maldigestion and Malabsorption
Maldigestion and Malabsorption
Lipids
Proteins and Amino Acids
Carbohydrates
Functional and Structural Aspects of the Enterocyte
Vitamins and Minerals
Special Situations
Diagnostic Considerations
Conclusion
32. Protracted Diarrhea
Introduction
Definition and Epidemiology
Classification of Protracted Diarrhea
Assessment of the Patient With Protracted Diarrhea
Congenital Diarrheal Disorders
Structural Abnormalities
Neonatal Diarrhea With Normal Crypt-Villus Structure
33. Protein-Losing Enteropathy
Definition
Lymph Formation and Composition
Pathophysiology and Etiologies of Protein-Losing Enteropathy
Diagnosis of Protein-Losing Enteropathy
Management
34. Celiac Disease
Definition
Historical Background
Cereal Proteins and Other Environmental Factors
Genetics
Epidemiology
Pathogenesis
Laboratory and Pathology Findings
HLA
Diagnosis
Therapy
35. Short Bowel Syndrome
Definition and Historical Perspective
Etiology and Prevalence
Pathophysiology of Short Bowel Syndrome
Clinical Management of Short Bowel Syndrome
Pharmacologic Management of Short Bowel Syndrome
Outcomes and Costs in Pediatric Short Bowel Syndrome
Summary
36. Intestinal and Multivisceral Transplantation: Recent Advances
Pathophysiology of Gut Failure
Principles of Gut Rehabilitation
Current Clinical Practice
Advances in Immunosuppression
Postoperative Management
Graft-Versus-Host Disease
Discharge Planning
Long-Term Outcome
Quality of Life
Summary
37. Allergic and Eosinophilic Gastrointestinal Disease
Overview
Food Allergy or Hypersensitivity
Eosinophilic Gastrointestinal Disease
Eosinophilic Esophagitis
Eosinophilic Gastroenteritis
Eosinophilic Proctocolitis
Other Manifestations of Gastrointestinal Allergy
Conclusion
38. Infectious Diarrhea
Multiplex Molecular Testing, an Introduction
Viral Gastroenteritis
Rotavirus
Virology
Epidemiology
Clinical Manifestations
Pathophysiology
Diagnosis
Treatment
Prevention
Small Round Structured Viruses
Other Viruses
Bacterial Gastroenteritis
Microbiology
Epidemiology
Pathogenesis
Diagnosis and Treatment
Pathogenesis
Yersinia
Cholera
Potential Diarrheagenic Organisms
Probiotics and Diarrhea
Conclusion
39. Enteric Parasites
Epidemiology
Host Factors
Clinical Presentations
Diagnosis
Polymerase Chain Reaction
Benefits of Parasites
Medication Difficulty
Pathogenic Organisms
40. Gastrointestinal Manifestations of Immunodeficiency
Introduction
Innate Versus Adaptive Immunity
Components of the Adaptive Immune Response
Humoral Immunodeficiencies
Cellular Immunodeficiencies
Combined Cellular–Humoral Immunodeficiencies
Disorders of Phagocyte Function
Other Primary Immunodeficiencies
Immune Dysfunction, Polyendocrinopathy, Enteropathy, X-Linked
Interleukin-10 Receptor Mutations
Approach to the Evaluation and Treatment of Very Early Onset Inflammatory Bowel Disease
Secondary Immunodeficiencies
41. Pediatric Polyposis Syndromes
Introduction
The Single Hamartomatous Polyp (the Juvenile Polyp)
Hamartomatous Polyposis Syndromes
Adenomatous Polyposis Syndromes
Other Polyposis Syndromes
Summary
42. Crohn Disease
Epidemiology of Crohn Disease
Clinical Presentation and Diagnosis of Crohn Disease
Diagnostic Workup of Children With Suspected Crohn Disease
Disease Classification
Classification of Crohn Disease
Very Early Onset Crohn Disease
Assessing Disease Activity and Outcomes in Crohn Disease
Therapy
Adjunctive Therapy
Transition to Adult Crohn Disease Services
Psychological Functioning and Support
Future
43. Ulcerative Colitis in Children and Adolescents
Epidemiology
Genetics
Etiology
Pathology
Clinical Features
Complications
Diagnosis
Differential Diagnosis
Medical Therapies
Surgery
Course and Prognosis
44. Chronic Intestinal Pseudo-Obstruction
Clinical Presentation
Pathophysiology
Diagnosis and Evaluation
Treatment
Nutrition
Medications
Surgery
Outcomes
45. Neonatal Necrotizing Enterocolitis
Epidemiology
Pathology
Pathogenesis
Clinical Manifestations
Diagnosis
Prevention
Management
Outcome
46. Disorders of the Anorectum: Fissures, Fistulas, Prolapse, Hemorrhoids, Tags
Anal Fissure
Rectal Prolapse
FistulaS
Hemorrhoids
Tags and Miscellaneous Conditions
Summary
47. Neoplasms of the Gastrointestinal Tract
Neoplasms of the Luminal Gastrointestinal Tract
Neoplasms of Lymphoid Origin
Lymphonodular Hyperplasia
Lymphoma
Neoplasms of Epithelial Origin
Carcinoma of the Colon
Carcinoma of the Stomach
Neuroendocrine (Carcinoid) Tumors
Neoplasms of Mesenchymal Origin
Smooth Muscle Origin
Stromal Cell Origin
48. Neoplasms of the Liver
Benign Masses
Malignant Masses
49. Other Diseases of the Small Intestine and Colon
Small Intestinal Bacterial Overgrowth
Microscopic Colitis
Celiac Crisis
Diverticular Disease
Ehlers–Danlos Syndrome
Hidradenitis Suppurativa
Typhlitis
Acrodermatitis Enteropathica
Mesenteric Adenitis
Henoch-Schönlein Purpura
50. Appendicitis
Introduction
Embryology and Anatomy
Pathophysiology
Pathology
Clinical Presentation
Patient Evaluation
Diagnostic Tests
Differential Diagnosis
Management Options
Complications
Discharge and Follow-Up Care
Chronic Appendiceal Pain
Section 6. Pediatric Surgical Disorders
51. Intussusception in Infants and Children
Introduction
Epidemiology
Pathophysiology
Clinical Presentation
Diagnosis
Treatment
Special Considerations
52. Inguinal Hernias and Hydroceles
Embryology
Clinical Presentation
Management
Complications
53. Meckel Diverticula and Other Omphalomesenteric Duct Remnants
Introduction
Clinical Presentation
Diagnosis
Treatment
Summary
54. Hirschsprung Disease
Etiology and Genetics
Clinical Presentation and Diagnosis
Surgical Management of Hirschsprung Disease
Postoperative Outcomes
“Variant” Hirschsprung Disease
Future Directions
55. Imperforate Anus
Classification and Description of Defects
Associated Defects
Early Management and Diagnosis
Main Repair
Functional Sequelae
56. Abnormal Rotation and Fixation of the Intestine
Embryology
Anatomy
Clinical Presentation
Diagnosis
Treatment
Complications, Results, Outcome
Summary
57. Small and Large Bowel Stenosis and Atresias
Duodenum
Jejunoileum
Colon
Summary
58. Newborn Abdominal Wall Defects
Historical Background
Embryogenesis
Etiology
The Evolution of Epidemiology
Anatomic Considerations
Prenatal Management
Obstetric Delivery
Immediate Postnatal Management
Surgical Management
Postoperative Complications
outcomes
Cost of Treatment
59. Stomas of the Small and Large Intestine
Introduction
Ileostomies
Surgical Techniques
Complications
Colostomies
Stomas for Feeding Purposes
Conclusions
Section 7. Gastrointestinal Procedures
60. Esophagogastroduodenoscopy and Related Techniques
Personnel
Facilities
Equipment
Indications
Contraindications
Antibiotic Prophylaxis
Preparation
Sedation and Monitoring
Anatomy
Technique
Biopsy Technique
Stomach
Therapeutic Endoscopy
Injection
Thermocoagulation
Heater Probe
Electrocoagulation
Stricture Dilation
Small Bowel Enteroscopy
Wireless Capsule Endoscopy
Percutaneous Endoscopic Gastrostomy
Percutaneous Endoscopic Jejunostomy
Polypectomy
Special Endoscopic Techniques
Endoscopic Ultrasonography
Chromoendoscopy and Narrow Band Imaging
Confocal Laser Endomicroscopy
Additional Techniques
Complications
Overall Complication Rates and Sedation Related Complications
61. Colonoscopy, Polypectomy, and Related Techniques
Personnel, Sedation, and Antibiotic Prophylaxis
Equipment
Indications
Contraindications
Preparation
Flexible Proctosigmoidoscopy
Anoscopy and Rigid Proctosigmoidoscopy
Biopsy Technique
Therapeutic Colonoscopy
Injection
Thermocoagulation: Heater Probe, Multipolar Probes
Argon Plasma Coagulation
Endoscopic Hemostatic Devices Including Bands and Clips
Laser Photocoagulation
Special Endoscopic Techniques and Equipment
Carbon Dioxide Insufflation
Water-Immersion Colonoscopy
Advanced Imaging Techniques
Complications
62. Endoscopic Retrograde Cholangiopancreatography
Pancreaticobiliary Imaging Methods
Indications for Endoscopic Retrograde Cholangiopancreatography
Contraindications to Endoscopic Retrograde Cholangiopancreatography
Preparation for Endoscopic Retrograde Cholangiopancreatography
Technique of Endoscopic Retrograde Cholangiopancreatography
Biliary Disorders
Choledocholithiasis
Choledochal Cyst
Biliary Strictures
Biliary Leaks
Unusual Biliary Infections
Biliary Dyskinesia
Pancreatic Disorders
Complications of Endoscopic Retrograde Cholangiopancreatography
Summary
63. Capsule Endoscopy and Small Bowel Enteroscopy
Equipment
Performance of Video Capsule Endoscopy Study
Indications
Limitations
Contraindications and Complications
Enteroscopy
Complications
Intraoperative Enteroscopy
Conclusion
64. Gastrointestinal Motility Procedures
Gastrointestinal Motility Studies
Esophageal Manometry
Antroduodenal Manometry
Colonic Manometry
Anorectal Manometry
Summary
65. Gastrointestinal Pathology
Esophageal Biopsy
Stomach Biopsy
Small Intestinal Biopsy
Interpretation of Colonic Mucosal Biopsy Specimens
Evaluation of Resection Specimens in Inflammatory Bowel Disease
Disorders of Intestinal Motility
Gastrointestinal Polyps and Polyposis Syndromes
66. Liver Pathology
Functional Anatomy and Histology of the Liver
Neonatal Cholestasis
Extrahepatic Biliary Obstruction Pattern
Giant Cell Hepatitis Pattern
Bland Cholestasis Pattern
Ductopenia Pattern
Chronic Liver Disease in Older Children
Miscellaneous Conditions Leading to Liver Biopsy
Liver Transplant Pathology
Summary
Liver Tumors in Children
Section 8. The Liver and Bile Ducts
67. Structural and Functional Development of the Hepatobiliary System
Introduction
Principles of Hepatobiliary Development In Humans and Other Model Organisms
Structural Development of the Hepatobiliary System
Functional Development of the Liver
Stem Cells and Liver Regeneration
Conclusion
Acknowledgments
68. Neonatal Hepatitis
Approach to the Infant With Cholestasis
Cholestasis Associated With Infection
Systemic Conditions Associated With Neonatal Hepatitis
Idiopathic Neonatal Hepatitis
Management of Neonatal Cholestasis
Summary
Acknowledgments
69. Biliary Atresia and Neonatal Disorders of the Bile Ducts
Surgically Correctable Disorders
Non–Surgically Correctable Disorders
70. Pediatric Cholestatic Liver Disease
Defects in Bile Acid Production
Other Inherited Cholestatic Disorders
Disorders of Embryogenesis: Alagille Syndrome
Disorders of Mitochondrial Function
α1-Antitrypsin Deficiency
Diagnosis of Genetic Cholestasis
Cholestatic Liver Conditions Without Genetic Explanations
71. Mitochondrial Hepatopathies: Disorders of Fatty Acid Oxidation and the Respiratory Chain
Defects In Fatty Acid Oxidation
Fatty Acid Transport Defects
Carnitine Transporter Deficiency
Carnitine Palmitoyl Transferase 1 Deficiency
Carnitine-Acylcarnitine Translocase Deficiency
Carnitine Palmitoyl Transferase 2 Deficiency
Very-Long-Chain Acyl-Coenzyme a Dehydrogenase Deficiency
Long-Chain 3-Hydroxyacyl-Coenzyme a Dehydrogenase and Mitochondrial Trifunctional Protein Deficiencies
Medium-Chain Acyl-Coenzyme a Dehydrogenase Deficiency
Short-Chain Acyl-Coenzyme a Dehydrogenase Deficiency
Acyl-Coenzyme a Dehydrogenase 9 Deficiency
Multiple Acyl-Coenzyme A Dehydrogenase Deficiency (Glutaric Acidemia Type 2)
Clinical Phenotypes
72. Abnormalities of Hepatic Protein Metabolism
α1-Antitrypsin Deficiency
Tyrosinemia
Treatment
Chronic Management and Laboratory Monitoring
73. Abnormalities of Carbohydrate Metabolism and the Liver
Nonalcoholic Fatty Liver Disease
Galactosemia
Hereditary Fructose Intolerance
Fructose-1,6-Bisphosphatase Deficiency
Glycogen Storage Disease
74. Nonalcoholic Fatty Liver Disease
Introduction
Natural History
Liver Biopsy
Routine Laboratory Tests and Novel Biomarkers
Imaging Techniques
Insulin-Sensitizing Agents
Conclusions
75. Acute and Chronic Hepatitis
Evaluation of the Child with Hepatitis
Hepatotropic Viruses
Autoimmune Hepatitis
Nonalcoholic Fatty Liver Disease
Treatment of Hepatitis
Summary
76. Portal Hypertension
Pathogenesis of Portal Hypertension
Disorders Associated With Portal Hypertension
Clinical Features
Summary
Acknowledgment
77. Liver Failure
Chronic Liver Failure
Acute Liver Failure
Summary
78. Liver Transplantation in Children
Indications for Liver Transplantation
General Contraindications for Liver Transplantation in Children
Evaluation of Pediatric Liver Transplantation Candidates
Preparation for Liver Transplantation
Organ Allocation
Liver Transplantation Surgery
Donor Operation
Recipient Operation
Posttransplant Management and Complications
Growth, Development, and Quality of Life
Nonadherence With Immunosuppression
Survival After Liver Transplantation
Liver Transplantation in Special Groups
Withdrawal of Immunosuppression and Tolerance
Conclusion
79. Diseases of the Gallbladder
Epidemiology of Gallstone Disease
Pathophysiology of Gallstone Disease
Cholesterol Stones
Pigment Stones
Gallstones in Infants
Total Parenteral Nutrition—Associated Stones
Cystic Fibrosis—Associated Gallstones
Ileal Disease and Ileal Resection—Associated Stones
Drug-Associated Stones
Diagnosis of Gallstone Disease
Treatment of Gallstone Disease
Cholecystitis
Choledocholithiasis (Common Bile Duct Stones)
Acalculous Cholecystitis
Acute Hydrops of the Gallbladder
Unusual Diseases of the Gallbladder
Acknowledgments
Section 9. The Pancreas
80. Pancreatic Development
Buds Form and Fuse
Ductal System Forms
Differentiation of Pancreatic Progenitors
Programmed Development by Hierarchical Signals
Regenerative Capacity of the Pancreas
Summary on Pancreatic Development
Pancreatic Secretion and Exocrine Function
81. Cystic Fibrosis and Congenital Anomalies of the Exocrine Pancreas
Cystic Fibrosis
Gastrointestinal Malignancies
Structural Abnormalities of the Pancreas
Functional Abnormalities of the Pancreas
82. Pancreatitis
Pediatric Pancreatitis
Definition and Classification
Acute Pancreatitis
Chronic Pancreatitis
Acknowledgment
83. Total Pancreatectomy With Islet Autotransplantation
Total Pancreatectomy with Islet Autotransplantation
Surgical Procedure of Total Pancreatectomy
Islet Isolation and Reintroduction
84. Pancreatic Neuroendocrine Tumors
Embryologic Origin of Pancreatic Neuroendocrine Tumors
Classification of Pnets—Functional and Nonfunctional, Sporadic and Hereditary
Grading and Staging
Inherited Syndromes
Nesidioblastosis
Insulinoma
Gastrinoma
Rare Functional Pancreatic Neuroendocrine Tumors
Locally Advanced/Metastatic Pancreatic Neuroendocrine Tumors
Conclusion
85. Infant and Toddler Nutrition
Introduction
Growth
Breastfeeding
Formula Feeding
Complementary Feeding
Supplements
Toddlers
Descriptive Information
Nutrient Information
Specific Nutrient Deficits
Eating the Right Amount of the Right Foods
Toddlers’ Nutrition and Stooling
Conclusion
Section 10. Nutrition
86. Nutritional Assessment
Normal Growth and Body Composition in Children
Prevalence and Classification of Malnutrition in Pediatric Patients
Indications for Nutrition Assessment
Management of Severe Malnutrition
Summary
87. Tubes for Enteric Access
Tubes to Remove Contents (Suction Tubes)
Tubes to add Content (Feeding Tubes)
Evaluation
Considerations for Short-Term Access
Considerations for Long-Term Access
Gastroesophageal Reflux and Feeding Tubes
Summary
88. Parenteral Nutrition
Indications
Route of Administration
Parenteral Nutrition Components and Requirements
Shortages
Monitoring
Complications
Total Nutrient Admixtures
Cyclic Parenteral Nutrition
Home Parenteral Nutrition
Monitoring The Home Parenteral Nutrition Patient
Summary
89. Enteral Nutrition
Background
Metabolic Implications of Enteral Versus Parenteral Route
Steps Preceding Initiation of Enteral Feeding
An Approach to Selecting the Type of Enteral Feeding
FAT
Carbohydrates
Protein
Vitamins and Minerals
Administration of Formula Feedings
Initiation of Feeds
Home Tube Feeding
Families of Children With Special Behavioral Issues
Discontinuing Enteral Feedings
Summary
90. Management of Diarrhea
Management of Acute Diarrhea
Pharmacologic Treatments
Management of Chronic Diarrhea
Conclusion
91. Effects of Digestive Diseases on Bone Metabolism
Introduction
Accretion of Bone Mass and Maintenance of Bone Mass
Bone Structure
Peak Bone Mass
Measurement of Bone Mass in Children
Definition of Osteoporosis in Children
Common Mechanisms by Which Digestive Diseases Affect Bone Mass
Selected Gastrointestinal and Liver Diseases Associated with Decreased Bone Mass
Treatment
92. Nutrition and Feeding for Children With Developmental Disabilities
Cerebral Palsy
Growth Failure and Malnutrition
Causes of Malnutrition
Laboratory Evaluation
Nutritional Goals
Obesity
Oral Feeding Evaluation
Conclusion
93. Fecal Transplant
Introduction
Fecal Microbiota Transplantation for rCDI
Investigational Uses of Fecal Microbiota
Conclusion
Acknowledgments
Index

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Pediatric Gastrointestinal and Liver Disease

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Robert Wyllie

Jeffrey S. Hyams

Marsha Kay