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Extrahepatic Portal Vein Thrombosis in Childhood: Risk Factors, Clinical Manifestations, and Management

Ivan Yankov1, Rayna Shentova-Eneva2, Hristo Mumdzhiev3

  • 1Department of Pediatrics, University Hospital "Saint George," Medical University of Plovdiv, Plovdiv, Bulgaria.

Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre
|October 10, 2022
PubMed

Insights

Extrahepatic portal vein thrombosis (EHPVT) in children is often linked to inherited clotting disorders and umbilical vein catheterization. Early ultrasound screening is recommended for at-risk pediatric patients.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Vascular Medicine

Background:

  • Extrahepatic portal vein thrombosis (EHPVT) is a significant cause of portal hypertension in pediatric populations.
  • Understanding EHPVT's clinical features and risk factors is crucial for effective management in children.

Purpose of the Study:

  • To identify the clinical manifestations of EHPVT in pediatric patients.
  • To determine the predisposing risk factors associated with the development of EHPVT in children.

Main Methods:

  • A single-center retrospective cohort study involving 12 pediatric patients diagnosed with EHPVT.
  • Analysis of clinical presentations, systemic and local risk factors, endoscopic findings of esophageal varices, and treatment approaches.

Main Results:

  • The most common initial symptom was upper gastrointestinal bleeding (50%), followed by splenomegaly (25%).
  • Key risk factors included inherited prothrombotic disorders (83.3%) and umbilical vein catheterization (41.7%).
  • All patients had esophageal varices (grade ≥2 in most cases); treatments included propranolol and surgical shunts.

Conclusions:

  • Proactive ultrasound screening is indicated for pediatric patients with known risk factors for EHPVT.
  • Early diagnosis and timely management are essential for improving outcomes in children with EHPVT.
Abstract

Keywords:
Extrahepatic portal vein thrombosisManifestationsRisk factors

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