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Ask Dr. Chip Your Own Question
Dr. Chip
Dr. Chip, Doctor (non-pediatrics specialty)
Category: Paediatrics
Satisfied Customers: 32225
Experience:  Many years of outpatient experience with all age groups
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Last month my daughter was diagnosed with Hepatitis A. She

Customer Question

Last month my daughter was diagnosed with Hepatitis A. She recovered after a few days. Soon afterwards my son developed similar symptoms. He was taken to hospital where his SGPT test indicated 1160 U/L. The doctor diagnosed him for Hepatitis A. After few days his urine and eyes got cleared, and he resumed normal diet. However recently he started complaining of abdominal pain and feeling of nausea, especially early morning and after eating. We did his LFT today and his results are: Total Bilirubin 1.4, Direct Bilirubin 0.51 and Indirect Bilirubin 0.89. His SGPT is 64. He is 7 years old and vaccinated against Hepatitis B.

Is he still suffering from jaundice? What is possibly causing the abdominal pain and nauseated feeling? IS HE OK?
Submitted: 3 years ago.
Category: Paediatrics
Expert:  Dr. Chip replied 3 years ago.
Hi--how long ago was he diagnosed with the hepatitis A? Where exactly is his abdominal pain and did he ever get either an ultrasound or a ct scan of his abdomen?
Customer: replied 3 years ago.
He was diagnosed on 17 March 2014. The doctor tested him for SGPT and the result was 1169 U/L. No he has not yet undergone an ultrasound or CT scan.
Expert:  Dr. Chip replied 3 years ago.
And was he actually tested for the hep A? And again--can you tell me more about his abdominal pain?
Customer: replied 3 years ago.
No he was not administered Hepatitis A antibody test (which is what my daughter was asked to undergo). The doctor just did the SGPT test and later told us that he was suffering from Hepatitis A. His pain is in the central part of abdomen, around the belly button. This pain happens off and on, especially early morning and after taking food. The doctor did a physical exam today and ruled out appendicitis.
Expert:  Dr. Chip replied 3 years ago.
OK. Since his SGPT has fallen that's a good sign but I would get the ultrasound or the ct scan since it now sounds like he might have a problem with his gall bladder and even someone his age can suffer from gallstones. He really should be over the hep A by now but he may have stones and one of the stones may have slipped out into his common bile duct and causing the pain. Even though this doesn't sound like appendicitis he really needs a scan to look for that and for the gallstones.
Expert:  Dr. Chip replied 3 years ago.
Hi--I keep getting a message that looks like you responded to my last post--if so was there more information you needed?
Customer: replied 3 years ago.
Thanks doc, I will get his ultrasound done tomorrow itself. Meanwhile why does he still have elevated total bilirubin (1.4) and SGPT (64), although other physical symptoms related to his initial condition (jaundice) have now gone away.
Expert:  Dr. Chip replied 3 years ago.
The bilirubin is only mildly elevated and if he has a stone problem that would explain it. It isn't high enough to cause jaundice. The SGPT while a bit high still could just be from the stone problem. Sounds like overall his liver is fine right now. Please let me know how it goes and please remember to rate my service to you
Customer: replied 3 years ago.
Thanks doc. One last question? Do you think he should be tested for Hepatitis C too? He was vaccinated against B while he was 2-3 years.
Expert:  Dr. Chip replied 3 years ago.
I see no reason for that--hepatitis A doesn't imply that someone also has hep C so I wouldn't bother with testing him for the hep C
Customer: replied 3 years ago.
Sorry for pestering you, but if he is indeed diagnosed with gall bladder stone, what are the treatment options?
Expert:  Dr. Chip replied 3 years ago.
No problem. In general if anyone has stones they really should have the gall bladder removed since a stone may slip out of the gallbladder and if it obstructs the common bile duct they can get pancreatitis which is a nasty thing to have. There are medications that can, in time, dissolve the stones but they will still come back after that medication is discontinued. Let me know what the scan shows tomorrow on a new page and we can continue to talk about all this but for now, since I have to be off line for a while, may I ask that you give me an excellent rating for the work I've done with you today? Thanks
Dr. Chip and other Paediatrics Specialists are ready to help you
Customer: replied 3 years ago.
As advised, my son underwent an abdominal ultrasound today. No gallstones were identified, however some enlarged mesenteric lymph nodes were seen. Is this OK, or something to worry about?
Expert:  Dr. Chip replied 3 years ago.
Is he having any pain in his right lower quadrant?
Customer: replied 3 years ago.
Occasional pain, comes and goes. Usually in the morning and after eating a meal. He doesn't complain of pain at other times (quiet active and agile).
Expert:  Dr. Chip replied 3 years ago.
OK--nothing to worry about here then. There is something called mesenteric adenitis that can mimic appendicitis but that resolves on its own without any treatment and isn't at all dangerous.
Customer: replied 3 years ago.
Phew! Thanks doc.
Expert:  Dr. Chip replied 3 years ago.
My pleasure again--any time