Extrahepatic portal vein thrombosis is associated with an increased incidence of cholelithiasis

Area of Science:

• Pediatric Gastroenterology
• Hepatology
• Vascular Surgery

Background:

• Extrahepatic portal vein thrombosis (EHPVT) is a condition affecting children, where the portal vein outside the liver is blocked.
• The impact of EHPVT on the liver's bile composition and biliary system in children is not well understood.
• This study focuses on the authors' experience with biliary tract problems in pediatric patients diagnosed with EHPVT.

Purpose of the Study:

• To investigate the prevalence and characteristics of biliary tract pathology in children with symptomatic idiopathic EHPVT.
• To assess the association between EHPVT and congenital anomalies or biliary abnormalities.
• To determine the incidence of symptomatic biliary pathology in this pediatric cohort.

Main Methods:

• Retrospective review of 29 children with symptomatic idiopathic EHPVT evaluated for the Rex shunt procedure over a 4-year period.
• Analysis of operative reports and pre- and postoperative abdominal ultrasound findings.
• Assessment for associated congenital anomalies and abnormal biliary tract findings.

Main Results:

• 24% of EHPVT patients had associated nonbiliary congenital abnormalities.
• 83% of patients exhibited detectable biliary tract pathology on ultrasound.
• Symptomatic biliary pathology (stones or sludge) occurred in 10.3% of all patients, with 33% of those with stones/sludge developing symptoms.
• No correlation found between biliary pathology and age, symptoms of portal hypertension, gender, or underlying condition.

Conclusions:

• A significantly high incidence of biliary tract pathology exists in children with EHPVT compared to the general population.
• Approximately 10% of pediatric patients with EHPVT in this series developed symptomatic biliary pathology.
• These findings underscore the importance of evaluating the biliary system in children diagnosed with EHPVT.