Liver nodules after portal systemic shunt surgery for extrahepatic portal vein obstruction in children.
BACKGROUND
Liver nodules have been reported after portal systemic shunt surgery (PSSS) in animal experiments or in humans with liver cirrhosis. The aim of our study was to assess the incidence of liver nodules after surgery for extrahepatic portal vein obstruction (EHPVO) in children without associated liver disease.


METHODS
We retrospectively reviewed the charts of 45 children who had surgery from 1979 to 2005 for EHPVO in our institution, consisting of 38 PSSS and 7 portal reperfusion procedures (PRPs). We assessed the presence of liver nodules on ultrasonography.


RESULTS
Of 45 patients, 7 (15%) had liver nodules during a median of 80 months of follow-up. All the nodules occurred after PSSS. Five nodules were subjected to biopsy; we found 2 liver cell adenomas and 3 focal nodular hyperplasias.


CONCLUSIONS
In this study, liver nodules occurred in 18% of cases after PSSS for EHPVO in children and not after PRP. As many children have undergone PSSS throughout the world, the presence of liver nodules should be considered during the follow-up of those patients.
Guérin
Florent
F
Department of Pediatric Surgery, Bicêtre Hospital, Assistance Publique Hôpitaux de Paris, University Paris XI, F94270 Le Kremlin-Bicêtre, France. florent.guerin-chir@bct.aphp.fr
Porras
Juan
J
Fabre
Monique
M
Guettier
Catherine
C
Pariente
Danièle
D
Bernard
Olivier
O
Gauthier
Frédéric
F
D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D011169:Portal Vein; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000175:diagnosis / Q000601:surgery*