Outcomes in Children With Umbilical Catheter-Related Portal Venous Thrombosis

Umbilical vein catheterization (UVC) is commonly used in neonatal intensive care units (NICUs). However, it poses a significant risk for portal venous thrombosis (PVT). The aim of this study was to evaluate the patients with PVT due to UVC in a NICU in terms of the development of chronic thrombus, portal hypertension (PHT), and possible additional complications in the long-term outcome.

Demographic, clinical characteristics, laboratory findings, ultrasonography imaging, and treatment of patients aged three years and younger who were diagnosed with PVT after UVC in the NICU and followed up by the pediatric gastroenterology outpatient clinic of our hospital were evaluated retrospectively.  Results: A total of 29 pediatric patients were analyzed. Isolated left PVT was seen in 25 (86.2%) patients and two-sided/bilateral PVT in four (13.8%) patients during hospitalization in the NICU. In the follow-up of four patients with combined right and left PVT who received anticoagulant therapy, the thrombus disappeared completely in three patients, whereas it persisted in one patient with partial recanalized flow in the left portal vein.

Long-term follow-up of these patients is important for the management of PHT. Since UVC is commonly used in NICU, routine ultrasound evaluation of these patients for thrombosis can enable the diagnosis of PVT in the asymptomatic period.