International Journal of Health and Clinical Research
Yazarlar: Richa, Manish Kumar, Anand Kumar Gupta, Rizwan Ahmar, Sunil Kishore, Amit Kumar, Shambhavi Sharan, Jayant Prakash
Konular:-
Anahtar Kelimeler:EHPVO,Esophageal varices,Gastric varices,Endoscopic retrograde cholangiopancreatography (ERCP),Endoscopic variceal band ligation,Splenectomy
Özet: Background:Extrahepatic portal vein obstruction (EHPVO) is an important cause of upper gastro intestinal bleeding in pediatric age group. In the majority of cases, the cause remains un-identified although it has diverse etiological factors. Objective of this study was to evaluate the clinical presentation, etiology, laboratory parameters, management and outcome of children admitted with EHPVO.Materials and methods: This was an observational and retrospective study done on thirty diagnosed cases of portal hypertension with EHPVO, selected by scrutinizing hospital data. Data items concerning patients’ demographics, laboratory and radiological workup, endoscopic and surgical procedures, growth and development, were collected from the patients’ clinical charts. Patients’ clinical presentation and etiology of EHPVO with management and outcome were analyzed. Statistical analysis was performed using SPSS version 19.0.Results: Out of 30 patients, 21(70%) were males. Median age was 4year 8 months. History of umbilical catheterization was present in six cases and history of omphalitis was present in two patients. The predominant presenting symptom was hematemesis (15 patients, 50%). Twenty-two patients (73.3%) had splenomegaly. Of 16 patients who underwent liver biopsy 9 had histological activity index stage of 1/6. Twenty-seven (90%) had esophageal varices on endoscopy while ten patients had gastric varices. Only one case underwent splenectomy due to severe pancytopenia. Endoscopic variceal band ligation was done in twenty-six patients (96.3%) with no post -procedural complication. Endoscopic retrograde cholangiopancreatography was performed in four patients (14.3%) due to portal biliopathy. Common bile duct stenting was performed in all four patients. Of them, one patient underwent splenorenal shunt operation for indication of hemobilia. Conclusion: - EHPVO is a not so uncommon disease in Bihar. The etiological factors are still not known in most cases. However, endoscopic and surgical treatment options can ensure a good long-term prognosis.