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Postoperative deaths in children with portal hypertension
Progress in Pediatric Surgery
|January 1, 1979
Insights
Portal hypertension in children can lead to fatal complications. Thrombosis following shunt surgery was a key factor in deaths, causing liver necrosis.
Area of Science:
- Pediatric Surgery
- Hepatology
- Vascular Surgery
Background:
- Portal hypertension is a serious condition in children.
- Surgical interventions are employed to manage portal hypertension.
- Complications associated with these surgeries require thorough investigation.
Purpose of the Study:
- To analyze the outcomes of surgical interventions for pediatric portal hypertension.
- To identify the causes of mortality in children undergoing surgery for portal hypertension.
- To investigate the role of thrombosis in post-surgical complications.
Main Methods:
- Retrospective analysis of 69 pediatric patients with portal hypertension.
- Review of surgical procedures including shunt and palliative surgeries.
- Post-mortem examination of deceased patients to identify causes of death.
Main Results:
- Mortality occurred in 9 out of 69 patients (13%).
- Five deaths followed shunt surgery, two followed palliative surgery, and two occurred pre-operatively due to hemorrhagic shock.
- Autopsies revealed portal vein thrombosis in all fatal shunt surgery cases, leading to partial liver necrosis.
Conclusions:
- Shunt surgery for pediatric portal hypertension carries a significant risk of mortality.
- Portal vein thrombosis is a critical complication post-shunt surgery, resulting in liver damage.
- Careful patient selection and monitoring are crucial for improving outcomes in pediatric portal hypertension management.
Abstract:
69 children suffering from portal hypertension have been analysed. 5 of these patients died following shunt surgery, 2 after palliative surgery and 2 died in a state of haemorrhagic shock before any treatment could be commenced. In all those patients who died following shunt surgery, thrombosis in some part of the portal vein was found at post mortem. This led to partial liver necrosis.