Extrahepatic portal vein thrombosis in childhood

  • \(\bf Objective:\) Extrahepatic portal vein thrombosis (EHPVT) is a common cause of portal hypertension in children. The aim of the present study was to identify the clinical manifestations and the risk factors for development of EHPVT in pediatric patients. \(\textbf {Subjects and Methods:}\) This was a single-center retrospective cohort study. A total of 12 children (6 boys and 6 girls) took part in the study. We noted the clinical presentations and the predisposing risk factors for development of EHPVT in all patients. In addition, as all of them had undergone an esophagogastroduodenoscopy for detection and grading of esophageal varices as part of the treatment algorithm, we analyzed the endoscopic findings and the therapeutic approach. \(\bf Results:\) The median age of subjects at diagnosis was 3.5 years (range: 1–17 years). The most frequent initial clinical manifestation was upper gastrointestinal bleeding (6 cases, 50.0%) followed by splenomegaly (3 cases, 25.0%). The most frequent systemic risk factor for EHPVT was presence of inherited prothrombotic disorder (10 cases, 83.3%), and the most common local risk factor for EHPVT was umbilical vein catheterization (5 cases, 41.7%). Esophageal varices were revealed in all the study participants, and in the most cases, they were grade \(\geq\)2. Propranolol was used as primary or secondary prophylaxis in 7 children (58.3%), and in 5 children (41.7%), a shunt was performed (Meso-Rex bypass in 3 children and splenorenal shunt in 2 children). \(\bf Conclusion:\) Patients with known systemic or local risk factors for EHPVT are indicated for proactive ultrasound screening for early diagnosis and timely management.

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Author:Ivan YankovGND, Rayna Shentova-EnevaORCiDGND, Hristo MumdzhievORCiDGND, Penka PetleshkovaGND, Maya KrastevaGND, Dimitar ChatalbashevGND, Penka StefanovaGND, Evgeniy MoshekovGND, Teodora GogovaGND
Parent Title (English):Medical principles and practice
Subtitle (English):Risk factors, clinical manifestations, and management
Place of publication:Basel
Document Type:Article
Date of Publication (online):2024/01/23
Date of first Publication:2022/10/10
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:Extrahepatic portal vein thrombosis; Manifestations; Risk factors
First Page:524
Last Page:531
Dieser Beitrag ist aufgrund einer konsortialen Lizenz frei zugänglich.
Institutes/Facilities:Klinikum Herford, Medizin Campus OWL, Klinik für Kinder- und Jugendmedizin
Dewey Decimal Classification:Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY-NC 4.0 - Attribution-NonCommercial 4.0 International