Portal vein thrombosis in children and adolescents.
OBJECTIVE
To review the literature on portal vein thrombosis in children and adolescents, focusing on its diagnosis, complications and treatment.


METHODS
The medical literature of the past 10 years was reviewed using the PubMed and MEDLINE search engines, with major focus on portal vein thrombosis and its clinical outcomes. The following keywords or expressions were used for the web search: portal vein thrombosis, extra-hepatic portal vein obstruction, prognosis, children, portal hypertension, esophagogastric varices. Additionally, we also reviewed the articles cited in the references of the initially selected papers, as well as relevant textbooks.


RESULTS
Portal vein thrombosis is one of the most common causes of portal hypertension among children. The initial clinical manifestation is characterized either by episodes of upper gastrointestinal bleeding or by splenomegaly on routine clinical examination. The major complications include upper gastrointestinal bleeding, hypersplenism secondary to splenomegaly, growth retardation, and portal biliopathy. The diagnosis is made by abdominal Doppler ultrasonography. Treatment is targeted at the complications and includes primary and secondary prophylaxis against upper gastrointestinal bleeding (which results from the rupture of esophageal varices), and portosystemic shunting in selected cases.


CONCLUSIONS
Portal vein thrombosis is one of the major triggers of upper gastrointestinal bleeding in children. Bleeding episodes have a remarkable effect on the quality of life of affected patients. Thus, appropriate diagnosis and treatment are needed in order to reduce morbidity and mortality.
Schettino
Graziela C M
GC
Pediatra especialista em Gastroenterologia Pediátrica, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brasil. g-schettino@uol.com.br
Fagundes
Eleonora D T
ED
Roquete
Mariza L V
ML
Ferreira
Alexandre R
AR
Penna
Francisco J
FJ
D000293:Adolescent; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000628:therapy; D011169:Portal Vein; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy