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

OBJECTIVE: Extrahepatic portal vein thrombosis (EHPVT) is a common cause of portal hypertension in children. The aim of the present study was to identify the clinical manifestations and the risk factors for development of EHPVT in pediatric patients. SUBJECTS AND METHODS: This was a single-center re...

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Autores principales: Yankov, Ivan, Shentova-Eneva, Rayna, Mumdzhiev, Hristo, Petleshkova, Penka, Krasteva, Maya, Chatalbashev, Dimitar, Stefanova, Penka, Moshekov, Evgeniy, Gogova, Teodora
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9841761/
https://www.ncbi.nlm.nih.gov/pubmed/36215953
http://dx.doi.org/10.1159/000527247
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author Yankov, Ivan
Shentova-Eneva, Rayna
Mumdzhiev, Hristo
Petleshkova, Penka
Krasteva, Maya
Chatalbashev, Dimitar
Stefanova, Penka
Moshekov, Evgeniy
Gogova, Teodora
author_facet Yankov, Ivan
Shentova-Eneva, Rayna
Mumdzhiev, Hristo
Petleshkova, Penka
Krasteva, Maya
Chatalbashev, Dimitar
Stefanova, Penka
Moshekov, Evgeniy
Gogova, Teodora
author_sort Yankov, Ivan
collection PubMed
description OBJECTIVE: Extrahepatic portal vein thrombosis (EHPVT) is a common cause of portal hypertension in children. The aim of the present study was to identify the clinical manifestations and the risk factors for development of EHPVT in pediatric patients. SUBJECTS AND METHODS: This was a single-center retrospective cohort study. A total of 12 children (6 boys and 6 girls) took part in the study. We noted the clinical presentations and the predisposing risk factors for development of EHPVT in all patients. In addition, as all of them had undergone an esophagogastroduodenoscopy for detection and grading of esophageal varices as part of the treatment algorithm, we analyzed the endoscopic findings and the therapeutic approach. RESULTS: The median age of subjects at diagnosis was 3.5 years (range: 1–17 years). The most frequent initial clinical manifestation was upper gastrointestinal bleeding (6 cases, 50.0%) followed by splenomegaly (3 cases, 25.0%). The most frequent systemic risk factor for EHPVT was presence of inherited prothrombotic disorder (10 cases, 83.3%), and the most common local risk factor for EHPVT was umbilical vein catheterization (5 cases, 41.7%). Esophageal varices were revealed in all the study participants, and in the most cases, they were grade ≥2. Propranolol was used as primary or secondary prophylaxis in 7 children (58.3%), and in 5 children (41.7%), a shunt was performed (Meso-Rex bypass in 3 children and splenorenal shunt in 2 children). CONCLUSION: Patients with known systemic or local risk factors for EHPVT are indicated for proactive ultrasound screening for early diagnosis and timely management.
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spelling pubmed-98417612023-01-17 Extrahepatic Portal Vein Thrombosis in Childhood: Risk Factors, Clinical Manifestations, and Management Yankov, Ivan Shentova-Eneva, Rayna Mumdzhiev, Hristo Petleshkova, Penka Krasteva, Maya Chatalbashev, Dimitar Stefanova, Penka Moshekov, Evgeniy Gogova, Teodora Med Princ Pract Original Paper OBJECTIVE: Extrahepatic portal vein thrombosis (EHPVT) is a common cause of portal hypertension in children. The aim of the present study was to identify the clinical manifestations and the risk factors for development of EHPVT in pediatric patients. SUBJECTS AND METHODS: This was a single-center retrospective cohort study. A total of 12 children (6 boys and 6 girls) took part in the study. We noted the clinical presentations and the predisposing risk factors for development of EHPVT in all patients. In addition, as all of them had undergone an esophagogastroduodenoscopy for detection and grading of esophageal varices as part of the treatment algorithm, we analyzed the endoscopic findings and the therapeutic approach. RESULTS: The median age of subjects at diagnosis was 3.5 years (range: 1–17 years). The most frequent initial clinical manifestation was upper gastrointestinal bleeding (6 cases, 50.0%) followed by splenomegaly (3 cases, 25.0%). The most frequent systemic risk factor for EHPVT was presence of inherited prothrombotic disorder (10 cases, 83.3%), and the most common local risk factor for EHPVT was umbilical vein catheterization (5 cases, 41.7%). Esophageal varices were revealed in all the study participants, and in the most cases, they were grade ≥2. Propranolol was used as primary or secondary prophylaxis in 7 children (58.3%), and in 5 children (41.7%), a shunt was performed (Meso-Rex bypass in 3 children and splenorenal shunt in 2 children). CONCLUSION: Patients with known systemic or local risk factors for EHPVT are indicated for proactive ultrasound screening for early diagnosis and timely management. S. Karger AG 2022-10-10 /pmc/articles/PMC9841761/ /pubmed/36215953 http://dx.doi.org/10.1159/000527247 Text en Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.
spellingShingle Original Paper
Yankov, Ivan
Shentova-Eneva, Rayna
Mumdzhiev, Hristo
Petleshkova, Penka
Krasteva, Maya
Chatalbashev, Dimitar
Stefanova, Penka
Moshekov, Evgeniy
Gogova, Teodora
Extrahepatic Portal Vein Thrombosis in Childhood: Risk Factors, Clinical Manifestations, and Management
title Extrahepatic Portal Vein Thrombosis in Childhood: Risk Factors, Clinical Manifestations, and Management
title_full Extrahepatic Portal Vein Thrombosis in Childhood: Risk Factors, Clinical Manifestations, and Management
title_fullStr Extrahepatic Portal Vein Thrombosis in Childhood: Risk Factors, Clinical Manifestations, and Management
title_full_unstemmed Extrahepatic Portal Vein Thrombosis in Childhood: Risk Factors, Clinical Manifestations, and Management
title_short Extrahepatic Portal Vein Thrombosis in Childhood: Risk Factors, Clinical Manifestations, and Management
title_sort extrahepatic portal vein thrombosis in childhood: risk factors, clinical manifestations, and management
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9841761/
https://www.ncbi.nlm.nih.gov/pubmed/36215953
http://dx.doi.org/10.1159/000527247
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