Article: Profile of extrahepatic portal venous obstruction among children in Central India

Introduction: There is a paucity of data regarding the clinical profile of children with extrahepatic portal venous obstruction (EHPVO) from Central India.

Material And Methods: Retrospective analysis of 30 children with EHPVO treated between 2002 and 2012.

Results: The median age of presentation was 12.5 years (range 5-14 years) and median duration of symptoms was 3.2 years (range 0.3-10 years). Home delivery was noted in 30 cases (100%), umbilical sepsis in 8 (27%) and history of cow dung application over the umbilical cord in 2 cases (6.7%). Twenty-two cases (73.4%) presented with upper gastrointestinal (GI) bleeding while 18 (60%) were referred for pancytopenia and/or hypersplenism. The patients underwent a median of 3.2 sessions of endoscopic therapy for varices. Most patients (19/30, 63.4%) dropped out of serial endotherapy due to the paucity of funds. Shunt surgery was performed in 7 patients.

Conclusions: Home delivery and umbilical sepsis are significant risk factors for EHPVO. Most patients present with GI bleeding and do well on endoscopic treatment/shunt surgery.

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References

1.

Sarin S, Agarwal S . Extrahepatic portal vein obstruction. Semin Liver Dis. 2002; 22(1):43-58. DOI: 10.1055/s-2002-23206. View

2.

Yadav S, Dutta A, Sarin S . Do umbilical vein catheterization and sepsis lead to portal vein thrombosis? A prospective, clinical, and sonographic evaluation. J Pediatr Gastroenterol Nutr. 1993; 17(4):392-6. DOI: 10.1097/00005176-199311000-00010. View

3.

Peter L, Dadhich S, Yachha S . Clinical and laboratory differentiation of cirrhosis and extrahepatic portal venous obstruction in children. J Gastroenterol Hepatol. 2003; 18(2):185-9. DOI: 10.1046/j.1440-1746.2003.02943.x. View

4.

Bhandarkar P, Sreenivasa D, Mistry F, Abraham P, Bhatia S . Profile of extrahepatic portal venous obstruction in Mumbai. J Assoc Physicians India. 2000; 47(8):791-4. View

5.

Chawla Y, Dilawari J, Katariya S . Gallbladder varices in portal vein thrombosis. AJR Am J Roentgenol. 1994; 162(3):643-5. DOI: 10.2214/ajr.162.3.8109513. View

6.

Kato T, Romero R, Koutouby R, Mittal N, Thompson J, Schleien C . Portosystemic shunting in children during the era of endoscopic therapy: improved postoperative growth parameters. J Pediatr Gastroenterol Nutr. 2000; 30(4):419-25. DOI: 10.1097/00005176-200004000-00013. View

7.

Mehrotra R, Bhatia V, Dabadghao P, Yachha S . Extrahepatic portal vein obstruction in children: anthropometry, growth hormone, and insulin-like growth factor I. J Pediatr Gastroenterol Nutr. 1997; 25(5):520-3. DOI: 10.1097/00005176-199711000-00006. View

8.

Chiu B, Superina R . Extrahepatic portal vein thrombosis is associated with an increased incidence of cholelithiasis. J Pediatr Surg. 2004; 39(7):1059-61. DOI: 10.1016/j.jpedsurg.2004.03.051. View

9.

Bhatia V, Jain A, Sarin S . Choledocholithiasis associated with portal biliopathy in patients with extrahepatic portal vein obstruction: management with endoscopic sphincterotomy. Gastrointest Endosc. 1995; 42(2):178-81. DOI: 10.1016/s0016-5107(95)70080-3. View

10.

Khuroo M, Yattoo G, Zargar S, Javid G, Dar M, Khan B . Biliary abnormalities associated with extrahepatic portal venous obstruction. Hepatology. 1993; 17(5):807-13. View

11.

Ni Y, Wang N, Peng M, Chou Y, Chang F . Bacteroides fragilis bacteremia associated with portal vein and superior mesentery vein thrombosis secondary to antithrombin III and protein C deficiency: a case report. J Microbiol Immunol Infect. 2003; 35(4):255-8. View

Profile of Extrahepatic Portal Venous Obstruction Among Children in Central India