Experience of pediatric liver disease at a university hospital in Western Saudi Arabia.

Objectives: To describe the diverse spectrum presented by pediatric liver diseases and prevalence of histopathological patterns and assess the role of histopathological findings in predicting prognosis.

Methods: We carried out a retrospective cohort study of 158 pediatric patients who underwent liver biopsy or resection for liver disease at King Abdulaziz University Hospital, Jeddah, Saudi Arabia (2014-2023). Demographic data, clinical data, and histopathological findings were analyzed using counts and percentages.

Results: The majority of the patients were infants (n=83; 52.5%), with male predominance (n=97; 61.4%). Biopsies were the most common specimen type (n=137; 86.7%). Cholestatic/bile duct disorders were the most prevalent pathological pattern (n=92; 58.2%), with extrahepatic biliary atresia being the most common subtype (n=32; 34.8%). Inflammatory/infectious disorders accounted for 13.3% (n=21) of cases, with chronic active hepatitis-not otherwise specified (n=10; 47.6%) being the most frequent. Metabolic disorders represented 12.0% of cases, with glycogen storage disorders and non-alcoholic fatty liver disease both at 31.6% (n=6). Neoplastic disorders were found in 7.6% (n=12) of cases, evenly distributed between benign and malignant tumors.

Conclusion: This study provides a comprehensive overview of histopathological patterns in pediatric liver diseases, highlighting the predominance of cholestatic disorders and the significance of early diagnosis.