Profile of Quality of Life in Children with Extrahepatic Portal Vein Obstruction: A Cross-sectional Comparative Study

Extrahepatic portal venous obstruction (EHPVO) is a chronic condition in children associated with recurrent gastrointestinal bleeding, hypersplenism, and growth impairment. While surgical and endoscopic interventions address portal hypertension, their impact on Health-related Quality of Life (HRQoL) remains incompletely understood.

This cross-sectional comparative study evaluated HRQoL using the Pediatric Quality of Life Inventory (PedsQL™ 4.0) in children with EHPVO undergoing endoscopic management (preshunt group), those who had undergone surgical intervention (postshunt group), and age-matched healthy sibling controls. Both child self-reports and parent proxy-reports were analyzed. Nonparametric statistical methods were used, and effect sizes were calculated to assess clinical relevance.

Children with EHPVO demonstrated significantly lower overall HRQoL compared with healthy controls across all domains (P < 0.001), with large effect sizes (r ≈ 0.8), indicating clinically meaningful impairment. No statistically significant difference was observed between pre- and postshunt groups, with small effect sizes suggesting minimal variation at the time of assessment. Median follow-up duration in the postoperative cohort exceeded 1 year across all surgical subgroups. Domain-wise analysis revealed the greatest impairment in school functioning, followed by physical and emotional domains. Strong concordance was observed between child self-reports and parent proxy-reports.

Children with EHPVO experience substantial impairment in HRQoL compared with healthy peers. While no significant differences were observed between treatment groups, HRQoL remains suboptimal within the follow-up period captured in this cross-sectional study. These findings highlight the need for comprehensive, multidisciplinary care addressing psychosocial, educational, and nutritional aspects alongside standard medical and surgical management.