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Signs and Symptoms of Liver Problems in Children

Your child has been diagnosed with a liver problem. This sheet describes some of the common signs and symptoms your child may experience. Some mean your child should go to the emergency room. Others are not as serious, but you should still tell your child’s doctor the first time you notice them.

Signs of an Emergency

If your child has any of these, go to the emergency room or call 911 RIGHT AWAY:

  • Mental status changes can include confusion, delirium, coma, and extreme sleepiness. These changes are due to a buildup of toxins that would normally be processed by the liver. They are signs that the liver isn’t working the way it’s supposed to.

  • Vomiting blood is a sign of bleeding in the upper GI (gastrointestinal) tract.

  • Bloody stool is a sign of bleeding in the GI tract. Blood in stool may be black and tarry, maroon colored, or bright red.

Signs of a Problem

The following may not be an emergency, but you should still alert your child’s doctor or clinic as soon as possible.

Woman holding boy in lap, talking on phone. Thermometer is on table.
If your child has liver disease and develops a fever, always call the doctor.

  • Jaundice occurs due to a buildup of bilirubin, a yellow substance made when the body breaks down red blood cells. The liver collects bilirubin to be sent out of the body with stool. When something is wrong with the liver or bile ducts, bilirubin may build up in the body. Signs of jaundice include yellowing of the skin and whites of the eyes, dark urine, or light-colored stool.

  • Abdominal pain can be a sign of a liver infection or inflammation.

  • Fever. Call the doctor at the first sign of fever. You will be asked questions to figure out whether the fever is due to a liver problem or something else.

    • In an infant under 3 months old, a rectal temperature of 100.4°F (39.0°C) or higher

    • In a child 3 to 36 months, a rectal temperature of 102°F (39.4°C) or higher

    • In a child of any age who has a temperature of 103°F (39.4°C) or higher

    • A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • A seizure caused by the fever

  • Swelling in the abdomen can be due to an enlarged liver or spleen. It can also be due to ascites (fluid in the abdomen). This can be caused by infection or abnormally high pressure in the blood vessels feeding the liver.

Signs of Chronic Liver Disease

The following often occur in children with chronic (ongoing) liver disease. These signs are not urgent, and can often be treated during your child’s regular doctor or clinic visits.

  • Bone fractures can occur more easily when a child has liver disease. This is because liver disease can lead to a decrease in bone density (thickness of bones). Of course, if your child breaks a bone, he or she needs medical care right away. But the fracture does not need to be reported to the child’s liver doctor until the next visit.

  • Itchy skin can occur due to a buildup of bile in the body.

  • Other skin problems, including spider veins, red palms, and itchy skin, can mean that blood isn’t flowing to and from the liver properly. Spider veins are often found on the hands, shoulders, and back.

  • Loss of appetite can occur due to liver disease. It may lead to malnutrition (the body not getting enough of the nutrients it needs).

  • Pale stools can be a sign that the liver is not making or releasing bilirubin, which normally colors the stools. Pale stools can also be due to liver infection or inflammation. Pale stools are also called acholic stools.

  • Easy bleeding and bruising may happen due to a lack of vitamin K or if the liver can’t use the vitamin K it receives.

  • Malnutrition may occur because the liver isn’t processing nutrients. A child with liver disease may have:

    • Poor growth because the diseased liver can’t absorb fat normally.

    • Rickets, a disease that causes low bone density (not enough tissue in the bone). Liver disease is a cause of rickets. Signs of rickets include being bowlegged and having ribs that stick out under the skin.

    • Weight loss because the liver can’t help the body use fat normally.

Online Medical Reviewer: Rosenthal, Philip, MD
Online Medical Reviewer: Squires, Jr, Robert, MD, FAAP
Last Review Date: 1/25/2012
© 2000-2014 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.