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Portal vein thrombosis children

Parisá Khodayar-Pardo, Andrés Peña Aldea, Ana Ramírez González, Adela Meseguer Carrascosa, Cristina Calabuig Bayo
Extrahepatic portal vein obstruction, although rare in children, is a significant cause of portal hypertension (PHT) leading to life-threatening gastrointestinal bleeding in the pediatric age group. PHT may also lead to other complications such as hyperesplenism, cholangyopathy, ascites, and even hepatopulmonary syndrome and portopulmonary hypertension that may require organ transplantation. Herein we report the case of an asymptomatic 11-month-old infant wherein a hepatomegaly and cavernous transformation of the portal vein was detected by liver ultrasound...
May 2016: Case Reports in Gastroenterology
Y H Chan, A Lt Ma, P C Tong, W M Lai, N Kc Tse
OBJECTIVE: To review the outcome for Chinese infants and young children on chronic peritoneal dialysis. METHODS: The Paediatric Nephrology Centre of Princess Margaret Hospital is the designated site offering chronic dialysis to children in Hong Kong. Medical records of children who started chronic peritoneal dialysis before the age of 2 years, from 1 July 1995 to 31 December 2013, were retrieved and retrospectively reviewed. RESULTS: Nine Chinese patients (male-to-female ratio, 3:6) were identified...
August 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
R Buzelé, L Barbier, A Sauvanet, B Fantin
Splenectomy is attended by medical complications, principally infectious and thromboembolic; the frequency of complications varies with the conditions that led to splenectomy (hematologic splenectomy, trauma, presence of portal hypertension). Most infectious complications are caused by encapsulated bacteria (Meningococcus, Pneumococcus, Hemophilus). These occur mainly in children and somewhat less commonly in adults within the first two years following splenectomy. Post-splenectomy infections are potentially severe with overwhelming post-splenectomy infection (OPSI) and this justifies preventive measures (prophylactic antibiotics, appropriate immunizations, patient education) and demands prompt antibiotic management with third-generation cephalosporins for any post-splenectomy fever...
August 2016: Journal of Visceral Surgery
Rajesh Krishnamurthy, LaDonna Malone, Karen Lyons, Pamela Ketwaroo, Nicholas Dodd, Daniel Ashton
Vascular pathology is ubiquitous in children. Common indications for angiographic imaging in the body include congenital anomalies, portal hypertension, assessing resectability of neoplasms, renovascular hypertension, vascular malformations, vasculitis, systemic vein thrombosis, and trauma. MR angiography, with or without the use of intravenous contrast agents, is therefore a mainstay in the repertoire of MR imaging in children. Pediatric contrast-enhanced MR angiography has benefited from several innovations in recent years, including improved hardware options like high-field-strength scanners and integrated high-density coil arrays, new sequences that combine parallel imaging, innovative k-space sampling and Dixon fat suppression with time-resolved imaging, new contrast agents with longer blood-pool residence time, and advanced post-processing solutions like image fusion...
May 2016: Pediatric Radiology
Kenichi Tetsuhara, Akira Ishiguro, Nobuaki Michihata, Sonoko Sensaki, Hisaya Nakadate, Yui Kimura, Daisuke Tomizawa, Kimikazu Matsumoto
OBJECTIVES: To investigate the clinical and epidemiologic characteristics of thromboembolism in Japanese children. METHODS: Clinical data of 77 patients with thromboembolism from a national tertiary pediatric care center were reviewed. RESULTS: Incidence of thromboembolism was calculated to be 15 per 10,000 hospital admissions. Infants younger than one year of age made up the largest age group (25 patients, including nine neonates younger than 30 d)...
October 2016: Indian Journal of Pediatrics
Rajesh Krishnamurthy, Sara M Bahouth, Raja Muthupillai
Unlike in adults, contrast agent-enhanced magnetic resonance (MR) angiography in the pediatric population raises unique challenges such as faster heart rates, more rapid arteriovenous transit, smaller structures, smaller volumes of contrast agent used, and more complex disease processes. A need exists for a rapid contrast-enhanced MR angiographic technique that can separate the arterial and venous phases of contrast enhancement in sedated pediatric patients breathing freely during the course of an examination...
March 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Topi T Luoto, Mikko P Pakarinen, Antti Koivusalo
BACKGROUND: Splenectomy is performed frequently for various and primarily hematologic indications in children and adolescents. We analyzed the long-term outcome after splenectomy (median, 8.7 years) focusing on sepsis, portal vein thrombosis (PVT), and retained accessory spleen. METHODS: In total, 141 consecutive children after open (n = 89; 63%) or laparoscopic (n = 52; 37%) splenectomy from 1991 to 2010 were followed up through nationwide registries for septic infections, PVT, and causes of death...
June 2016: Surgery
Gloria Chocarro, Paloma Triana Junco, Eva Dominguez, María Virginia Amesty, Vanesa Nuñez Cerezo, Francisco Hernandez, Javier Murcia, Juan Antonio Tovar, Manuel Lopez Santamaria
OBJECTIVE: The mesoportal shunt (MPS) and liver transplantation (LT) have changed the scenario of extrahepatic portal vein obstruction (EHPVO) since the MPS, the only "curative" technique, can now be offered in asymptomatic patients and also thrombotic complications of LT have increased the incidence of EHPVO. MATERIAL AND METHODS: A retrospective study of patients undergoing surgery for EHPVO was conducted between 1990 and 2015. An analysis was done for the shunt permeability and clinical evolution over time...
February 2016: European Journal of Pediatric Surgery
Hui Ye, Qiang Zhao, Yufang Wang, Dongping Wang, Zhouying Zheng, Paul Michael Schroder, Yao Lu, Yuan Kong, Wenhua Liang, Yushu Shang, Zhiyong Guo, Xiaoshun He
OBJECTIVE: To overcome the shortage of appropriate-sized whole liver grafts for children, technical variant liver transplantation has been practiced for decades. We perform a meta-analysis to compare the survival rates and incidence of surgical complications between pediatric whole liver transplantation and technical variant liver transplantation. METHODS: To identify relevant studies up to January 2014, we searched PubMed/Medline, Embase, and Cochrane library databases...
2015: PloS One
Benjamin L Shneider, Jean de Ville de Goyet, Daniel H Leung, Anshu Srivastava, Simon C Ling, Mathieu Duché, Patrick McKiernan, Riccardo Superina, Robert H Squires, Jaime Bosch, Roberto Groszmann, Shiv K Sarin, Roberto de Franchis, George V Mazariegos
UNLABELLED: Approaches to the management of portal hypertension and variceal hemorrhage in pediatrics remain controversial, in large part because they are not well informed by rigorous clinical studies. Fundamental biological and clinical differences preclude automatic application of approaches used for adults to children. On April 11-12, 2015, experts in the field convened at the first Baveno Pediatric Satellite Meeting to discuss and explore current available evidence regarding indications for MesoRex bypass (MRB) in extrahepatic portal vein obstruction and the role of primary prophylaxis of variceal hemorrhage in children...
April 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Sheng-Chun Yang, Chia-Jung Huang, Chao-Long Chen, Chih-Hsien Wang, Shao-Chun Wu, Tsung-Hsiao Shih, Sin-Ei Juang, Ying-En Lee, Bruno Jawan, Yu-Feng Cheng, Kwok-Wai Cheng
AIM: To compare the outcomes of pediatric patients weighing less than or more than 10 kg who underwent liver transplantation. METHODS: Data for 196 pediatric patients who underwent living donor liver transplantation between June 1994 and February 2011 were reviewed retrospectively. The information for each patient was anonymized and de-identified before analysis. The data included information regarding the pre-transplant conditions, intraoperative fluid replacement and outcomes for each patient...
June 21, 2015: World Journal of Gastroenterology: WJG
Gökhan Moray, Tugan Tezcaner, Aydıncan Akdur, Figen Özçay, Atilla Sezgin, Mahir Kırnap, Sedat Yıldırım, Gülnaz Arslan, Mehmet Haberal
OBJECTIVES: Liver transplant is an established curative therapy for children with chronic end-stage liver disease or acute liver failure. In this study, we aimed to evaluate pediatric liver transplant in terms of outcomes, complications, and long-term followup results. MATERIALS AND METHODS: Pediatric patients who had liver transplant in our institution were included. We retrospectively evaluated demographic features including body weight, Child-Pugh score, etiology of liver disease, graft source, perioperative outcomes, perioperative complications, postoperative complications, and long-term results...
April 2015: Experimental and Clinical Transplantation
Fabrizio di Francesco, Laura Del Prete, Chiara Grimaldi, Lidia Monti, Jean de Ville de Goyet
BACKGROUND: The association of pancreatitis and portal vein thrombosis (PVT) is extremely rare in children. We report on 3 cases which suggest that there may be a causal relation between the two. METHODS: Clinical characteristics and evolution of 3 children with this particular condition were analyzed retrospectively. In this group of patients, the strategy consisted in opting for early surgical decompression of the portal hypertension, which was followed by a favorable outcome, not only in terms of complications related to the portal hypertension but also of a contemporaneous spontaneous regression of the concurrent pancreatic disease, in absence of any other specific management of the latter problem...
April 2015: Journal of Pediatric Surgery
S Jayakumar, A Odulaja, S Patel, M Davenport, N Ade-Ajayi
AIM OF THE STUDY: To report the outcomes of children who underwent Sengstaken-Blakemore tube (SBT) insertion for life-threatening haemetemesis. METHODS: Single institution retrospective review (1997-2012) of children managed with SBT insertion. Patient demographics, diagnosis and outcomes were noted. Data are expressed as median (range). MAIN RESULTS: 19 children [10 male, age 1 (0.4-16) yr] were identified; 18 had gastro-oesophageal varices and 1 aorto-oesophageal fistula...
July 2015: Journal of Pediatric Surgery
Brandon M Wojcik, Sarwar Zahid, Shijie Cai, Michael J Englesbe
BACKGROUND/OBJECTIVES: The optimal management of children with noncirrhotic portal hypertension is controversial. Some groups suggest early and aggressive surgical intervention, while others report long-term success with conservative management. METHODS: We conducted a retrospective study of 26 patients with noncirrhotic portal hypertension treated at our institution. We compared platelet counts, white blood cell (WBC) counts, spleen size, hospital admissions, gastrointestinal bleeds, and longitudinal trends of specific clinical parameters using standard univariate and time-trend analytic techniques...
December 2011: Journal of Clinical and Experimental Hepatology
Smita Malhotra, Anupam Sibal, Vidyut Bhatia, Akshay Kapoor, Sarath Gopalan, Swati Seth, Nameet Jerath, Manav Wadhawan, Subash Gupta
OBJECTIVE: To study the clinical, biochemical profile and outcome of patients with biliary atresia (BA) who underwent living related liver transplantation (LRLT) at authors' institute in the last 5 y (2008-2013). METHODS: Case records of the 20 patients diagnosed with biliary atresia who had undergone living related liver transplantation at authors' centre in the last 5 y were analysed. RESULTS: Eighteen patients with BA with a failed Kasai procedure and 2 without a prior Kasai's portoenterostomy received a liver transplant...
October 2015: Indian Journal of Pediatrics
Olga Giouleme, Ioannis Xinias, Antigoni Mavroudi, Nikolaos Grammatikos
No abstract text is available yet for this article.
January 2015: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Hanaa M El-Karaksy, Nehal El-Koofy, Nabil Mohsen, Heba Helmy, Nevian Nabil, Mortada El-Shabrawi
BACKGROUND AND AIM: Extrahepatic portal vein obstruction (EHPVO) is an important cause of portal hypertension in children. The aim of this study was to describe the clinical presentation, possible risk factors, upper gastrointestinal endoscopic findings, and treatment modalities of children with EHPVO. METHODS: After ethical approval of our study protocol by our institution review board, we analyzed available data from medical records of patients with EHPVO presenting to the Pediatric Hepatology Unit, Cairo University Pediatric Hospital, Egypt, for a period of 15 years from January 1996 to December 2010...
January 2015: Journal of Pediatric Gastroenterology and Nutrition
Zhang Wei, Shao Guang Rui, Zhang Yuan, Li Dian Guo, Liu Qian, Liu Shu Wei
BACKGROUND: Meso-Rex bypass (MRB) surgery is being increasingly used to treat chronic prehepatic portal hypertension secondary to extrahepatic portal vein thrombosis (EPVT) and cavernous transformation (EPVCT) in children. Rather than using the internal jugular vein (IJV, the traditional venous graft), we used an autogenous splenic vein segment graft for MRB. MATERIAL/METHODS: We examined 25 children with extrahepatic portal hypertension and a history of recurrent upper gastrointestinal (GI) variceal bleeding despite previous endoscopic sclerotherapy...
2014: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Agostino Colli, Juan Cristóbal Gana, Dan Turner, Jason Yap, Thomasin Adams-Webber, Simon C Ling, Giovanni Casazza
BACKGROUND: Current guidelines recommend performance of oesophago-gastro-duodenoscopy at the time of diagnosis of hepatic cirrhosis to screen for oesophageal varices. These guidelines require people to undergo an unpleasant invasive procedure repeatedly with its attendant risks, despite the fact that half of the people do not have identifiable oesophageal varices 10 years after the initial diagnosis of cirrhosis. Video capsule endoscopy is a non-invasive test proposed as an alternative method for the diagnosis of oesophageal varices...
2014: Cochrane Database of Systematic Reviews
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