Table 3.
Evaluation of children and adolescents with cirrhosis
| Clinical history |
| Age, sex, ethnicity |
| Pregnancy and birth data: Adverse events during pregnancy, maternal serologies, birthweight, neonatal cholestasis, surgery, TPN |
| Signs and symptoms of systemic disease: anorexia, fatigue, muscle weakness, failure to thrive |
| Nausea, vomiting, abdominal pain, diarrhea, dyspepsia |
| Jaundice, pruritus, discoloration of urine and feces |
| Abdominal distension |
| Peripheral edema |
| Bleeding - nose, gums, skin, gastrointestinal tract |
| Bone pain, fractures |
| Adolescence: Menstrual history |
| Previous medical history: Jaundice, hepatitis, drug use, blood transfusions, inflammatory bowel disease |
| Social behaviors (adolescence): Use of alcohol or other drugs, tattoos, piercings |
| Family history: Consanguinity, liver disease, autoimmune disease |
| Physical examination: |
| General: Anthropometric data (malnutrition or obesity), fever |
| Skin and extremities: jaundice, flushing or pallor, spider nevi, telangiectasias, palmar erythema, clubbing of the nails, xanthoma, Terry’s nails |
| Abdomen: Distension, prominent blood vessels, liver and spleen alterations (reduced liver size, splenomegaly) |
| Neurological alterations: Academic performance, sleep, asterixis, positive Babinski sign, mental status changes |
| Miscellaneous: Pubertal delay, gynecomastia, testicular atrophy, feminization |