• Cholangitis

This is an infection of the bile ducts in the liver resulting in inflammation.
This may cause a fever or jaundice or both. It requires urgent treatment with intravenous antibiotics which can only be given at your local hospital or the Unit treating your child. If the treatment is given locally, please ask the doctors to contact the Liver Unit treating your child, if you attend one.

If cholangitis is left untreated it can cause further damage to liver. That is why prompt investigation of any high temperature (over 37⁰ C) or a non-specific illness lasting for than 24 hours is important.

• Ascites

This is pronounced Ay – sigh – tees and is an abnormal collection of fluid in the abdomen. This can be present for up to 6 weeks after the operation but should then disappear. If it recurs at any time this is usually a sign that the disease has affected the ability of the liver to make a protein called albumin.

One of the blood tests performed frequently after the operation and each time blood is taken in outpatients is to measure the albumin level. When the albumin level is too low, water from child’s blood "leaks" out of the blood vessels and collects in the abdomen (in severe cases it may also collect in other parts of body).

The first sign of this problem is often when clothes do not fit so well over the tummy. This usually occurs gradually but may be started or worse by infection.

The doctor may measure your child’s abdominal girth at each hospital visit and/or may ask you to do this at home. If your child’s tummy becomes noticeably bigger while at home you should see your GP to exclude other causes such as wind or constipation for which he/she can advise you. Treatment for ascites may also be started by your GP or your local pediatrician in consultation with the specialist unit and does not necessarily mean admission to hospital.

Treatment is initially by medicine and/or altering the diet to maintain calorie in take but reduce fluid and salt intake. In more serious cases it may be necessary to admit your child to hospital and give albumin intravenously through a "drip". You should never attempt to alter your child’s diet and, in particular, their fluid intake without medical advice.