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IP International Journal of Medical Paediatrics and Oncology


Non-Bleeding Manifestations in Children with Extrahepatic Portal Vein Obstruction


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Author Details: P. Karthikeyan, B. Sumathi, D. Nirmala, Bhaskar Raju, K. Neduchelian

Volume : 1

Issue : 1

Online ISSN : 2581-4702

Print ISSN : 2581-4699

Article First Page : 6

Article End Page : 10


Abstract

Background: Extra hepatic portal venous obstruction is the commonest type of portal hypertension (EHPVO) in children1-3, apart from variceal bleeding4,5, other features include anemia, hypersplenism5, protein losing enteropathy, growth retardation6 and portal biliopathy.
Aim: To study the bleeding and non-bleeding manifestations in South Indian children with EHPVO.
Study Design: A prospective descriptive study on children from 1-12yrs of age with (EHPVO) from a tertiary care pediatric centre in Chennai-India. Study period - one year.
Materials and Methods: Children with EHPVO were recruited based on clinical features, USG abdomen findings, liver function tests with or without varices on upper GI endoscopy. They were divided into 2 groups; Bleeders (group 1) and non-bleeders (group 2).
Statistical Analysis Used: Chi square test, Student t test.
Results: There were 48 children with male, female ratio of 0.9:1. History of umbilical sepsis was present in 20.8%. Recurrent variceal bleed was the common presentation seen in the majority (83.3%) more so in rural children between 5-15 years (p- 0.025). Non - bleeding manifestations observed were splenomegaly (95.8%), hypersplenism (37.5%) as age advances (p-0.038), anemia (91.6%), ascites (10.4%), epistaxis (6.25), growth retardation less than 3rd centile (22.7%). Associated comorbid conditions include insulin dependent diabetes mellitus (4%), atrial septal defect (2%).
Conclusions: Upper GI bleeding was the common presentation in majority of  children between 5-15 years in group 1 and in group II  hypersplenism (37.8%), anemia ( 91.6%) 2 were common. Deranged liver function was noted in 10.4% and growth retardation in 22.7%. One should look for associated congenital anomalies though rare in children.

Key words:  EHPVO, Non-Bleeding manifestations