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Drugs and toxic induced hepatopathies in children are commented, analyzing their types and mechanisms of toxicity, metabolism of drugs in the liver, classification and main clinical syndromes founded. A practical management of diagnosis, therapeutic and prophylactic measures are briefly described.

Hepatic peliosis is a morphologic entity characterized by the presence in the liver of blood-filled cystic spaces. These can be single or multiple, and of variable size. The internal surface of these cavities is covered by endothelial cells and adjacent hepatocytes can be normal or show atrophic or degenerative changes. The cavities contain liquid blood, suggesting that it circulates. Its etiology is unknown but it has been related to drugs, ingestion of toxins and diverse tumoral or inflammatory diseases. The morphogenesis of peliosis is also controversial. For some it is the consequence of increased sinusoid pressure because of difficulties in blood outflow from the liver. For others it is the result of the disappearance, by necrosis of liver cells, while for others it is due to sinusoid wall weakness. The lesion can be silent so that it is probable that its prevalence is higher than has been estimated. Eventually the cysts originate complication particularly hemoperitoneum. Only in these cases is the adoption of specific therapeutic measures, concretely hepatectomy, justified.