My 6-year-old son has a diaphragm problem. He has a heart problem post operated for VSD and having pacemaker from his 11th month. Now he have a new problem like vomiting, urine problem, fatty liver, gall bladder wall thickening, mega cardio, 30 percent heart function only. What is the main problem here? And what treatment to give?
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I am very much concerned about all the problems your son is going through. Now, he has a few different issues overall not a single problem.
His urinary problem looks like due to inflammation of urinary bladder called cystitis, which needs investigation of urine and if needed antibiotics for that.
His heart functions are weak and that may be leading to fluid accumulation and back pressure on the liver leading to gall bladder thickening and liver congestion and enlargement. He may also be having some edema in his feet or some fluid in the abdomen.
Kindly send me his ultrasound and all the reports recently done so that I can decide about his proper treatment and guide you accordingly.
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Thank you doctor,
I have attached all reports.
Welcome back to icliniq.
Thank you very much for getting back to me with the reports. (attachment removed to protect patient identity).
I reviewed the echocardiography and US abdomen report. His echo shows that his heart is not able to pump blood effectively which is leading to pooling of blood back into the lungs and increasing pressure in it which is called pulmonary hypertension and this increased pressure is also causing back pressure on his liver leading to the increasing size of the liver and accumulation of some free fluid in the abdomen. Because of this free fluid his gall bladder wall looks thickened. All these issues in gall bladder, liver enlagement, and fluid in tummy are secondary to ineffective pumping by the heart, which once controlled, leads to improvement of these things.
These issues in abdomen does not need any treatment. He should be consulted with cardiologist to manage his failing heart. Meanwhile, I am prescribing medicines for his vomiting and foamy urine.
Give syrup. Domperidone 1 teaspoon three times daily before meals for 10 days, syrup. Cefixime DS 200 mg / 5ml one teaspoon (5 ml) once daily for five days.
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