Total and differential leukocytic counts did not show any constant deviation from normal.

**4.5. Other tools of investigations [14]**

**5.1. Preventive measures:**

**•** Good nutrition of the mother

**5.2. Conservative measures :**

**5.3. Medical treatment:**

**•** *Anti inflammatory* or *steroids.*

HVOD [15], [16], [17].

**•** *Diuretics* for ascites.

help its nutrition.

**•** The ascitic fluid is a main laboratory field of investigations. It usually shows protein val‐

Egyptian Hepatic Veno-Occlusive Disease: Surgical Point of View

http://dx.doi.org/10.5772/50685

553

**•** Other sophisticated modules of investigations might be carried out : liver isotopic scan‐

No effective therapy until now especially in this type of Egyptian children. The target of available line is, may be, to reduce the complications, to reduce the stress of the patients and keep the patients in nearly comfortable life, but the following measures could be used safely [14].

**•** More investigation for the etiology of the disease especially pyrrolizidine alkaloids.

**•** What about copper utensils ?? it suspected to play a role in indian cirrhosis !

**•** Encouraging the breast feeding for two years as Glorious Qura'n says. (Sorra El bakara ),

**•** Follow up, because a grossly abnormal scan of liver and spleen in a patient with HVOD

**•** Use of *Vit C, u*se of *Vit. E* and Glutamine (source of glutathione) as antioxidants [15].

**•** Use of *recombinant tissue plasminogen activator* (rtPA), especially in patients after BM trans‐ plantation, *Urokinase* especially in cases with bleeding diathesis leading to thrombotic

**•** *Large doses of glucose* together with *insulin* to aid glycogen deposition in the liver and so

ues ranging between 1-3.5 gms/dl with occasional lymphocytes.

**5. Management of Hepatic veno-occlusive disease:**

regulation and careful inspection of diet after weaning [11].

has been normalized completely without any interference.

**•** Low doses of *heparin or anticoagulants*, adapted dose of *prostacyclin.*

**•** Colonic lavage to wash out the toxic metabolites.

**•** Cupper chelation treatment (Di-penecillamine)

ning, splenoportal venogram and arterio-venography of the portal system.
