Interventional treatment of children with portal hypertension secondary to portal vein occlusion.
OBJECTIVE
To present methods and results of interventional treatment of children with portal hypertension (PH) secondary to portal vein occlusion (PVO).


METHODS
Five children, four boys and one girl, 8 - 14 years old, with symptomatic PH secondary to PVO were treated. All children had one or more episodes of bleeding from oesophageal varices, enlarged spleen and thrombocytopenia. Partial embolisation of the spleen was performed in four children. Attempts to recanalize the occluded part of the portal vein were done in all children using transjugular (n = 4), transhepatic (n = 4) and transsplenic (n = 3) approaches.


RESULTS
All procedures were carried out without serious complications and were followed by normalisation of the platelet count, decrease in splenic size and disappearance of bleeding. Recanalisation of the occluded portal vein with a stent was possible in one child and partial stent recanalisation was possible in another child. Transjugular intrahepatic portosystemic shunt (TIPS) with partly extrahepatic, intraperitoneal route was created in one patient. All children were scheduled for follow-up. During the observation time of 22 months (5 - 46 months), additional balloon dilation and placement of new stents were necessary in two children.


CONCLUSIONS
Interventional procedures are valuable in the treatment of children with symptoms secondary to PVO. Treatment should be customized and scheduled follow-ups of the patients are necessary.
Cwikiel
W
W
Department of Radiology, University Hospital, Lund, Sweden.
Keussen
I
I
Larsson
L
L
Solvig
J
J
Kullendorff
C-M
CM
D000293:Adolescent; D002648:Child; D004621:Embolization, Therapeutic; D019723:Endoscopes; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000628:therapy*; D008297:Male; D011169:Portal Vein; D011170:Portasystemic Shunt, Surgical; D015911:Sclerotherapy; D013154:Spleen; D014652:Vascular Diseases / Q000150:complications* / Q000209:etiology