Extrahepatic portal vein thrombosis in children: etiology and long-term follow-up.
OBJECTIVE
Mortality of extrahepatic portal vein thrombosis depends on underlying causes other than gastrointestinal bleeding. The aim of this study was to evaluate the etiology, treatment, and prognosis of patients with extrahepatic portal vein thrombosis.


METHODS
The records of 12 patients (age range: 1-9 years) diagnosed with extrahepatic portal vein thrombosis with a minimum follow-up of 2 years were analyzed retrospectively. Their diagnostic evaluations, treatment modalities, complications and long-term follow-ups were noted.


RESULTS
Mean follow-up period was 7.4 +/- 3.9 years (2-14 years). Hemorrhage from esophageal varices was the prevalent symptom in 6 patients (50%). Six patients had signs of hypersplenism, 5 were found to have thrombophilia: 2 protein C, 1 protein S, 1 combined protein S, C, and antithrombin III deficiency, and 1 homozygous factor V Leiden mutation. Two patients had congenital cardiovascular abnormalities, and 1 patient developed portal thrombosis after splenectomy operation. None of the patients who started propranolol prophylaxis before first bleeding episode bled during their follow-up periods. Endoscopic sclerotherapy succeed in 66.6% variceal hemorrhages. Shunt surgery was performed in 1 patient. The patients neither faced a life-threatening variceal bleeding nor died during follow-up period.


CONCLUSIONS
Prognosis of extrahepatic portal vein thrombosis is good in childhood. Thrombophilic states are the most frequent precipitating causes. Propranolol for prophylaxis of variceal bleeding and sclerotherapy might be the preferred modalities.
Gürakan
Figen
F
Hacettepe University, Faculty of Medicine, Department of Pediatrics, Ankara, Turkey.
Eren
Makbule
M
Koçak
Nurten
N
Yüce
Aysel
A
Ozen
Hasan
H
Temizel
Inci Nur Saltk
IN
Demir
Hülya
H
D002648:Child; D002675:Child, Preschool; D020776:Endoscopes, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008099:Liver / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D011169:Portal Vein; D020246:Venous Thrombosis / Q000209:etiology / Q000473:pathology*