DIFFERENTIAL-DIAGNOSIS OF POSTOPERATIVE LIVER-FAILURE IN A 12-YEAR-OLD CHILD

The case of a 12-year-old child who died of fulminant hepatic failure a few days after tonsillectomy is reported. Histological examination r evealed large areas of massive centrilobular hepatic necrosis. Hepatot oxity of postoperatively administered paracetamol in high dosages comb ined with enflurane exposure is discussed as a cause for the hepatic f ailure. The fulminant clinical course could have been influenced by an infection with hepatitis G virus which was detected in liver tissue b y in situ hybridisation and was probably transmitted via transfusion o f blood plasma.