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Archivos de Pediatría del Uruguay
On-line version ISSN 1688-1249
Abstract
MAURENTE, Lucía et al. Cavernoma de la vena porta: Descripción de casos clínicos pediátricos . Arch. Pediatr. Urug. [online]. 2012, vol.83, n.4, pp.266-272. ISSN 1688-1249.
Summary Cavernous portal is a frequent pathology caused by thrombosis of the portal vein. Is the main cause of portal hypertension in children. Although often the cause is not identified, predisposing factors can be recognized, among which the most common are umbilical vein catheterization and omphalitis. Is manifested through its complications: upper gastrointestinal bleeding caused by esophageal varices and splenomegaly. Diagnosis is confirmed by abdominal ultrasound Doppler. Therapy includes medical endoscopic treatment of esophageal varices. The portal obstruction is resolved by porto-systemic shunt surgery. A retrospective study was performed in order to describe the clinical characteristics of patients with cavernous portal in the period January 1999 to April 2009 at Children's Hospital Center Hospital Pereira Rossell (HP-CHPR). Eight patients were identified with a average age at diagnosis of 2 years and 2 months. Hematemesis was the most frequent form of presentation. Most of them showed splenomegaly. In three of them predisposing factors were identified: umbilical catheterization, abdominal surgery. All had esophageal varices at diagnosis. Three patients repeated upper gastrointestinal bleeding, one in three and another in four opportunities. Four patients required sclerotherapy or variceal banding for his esophageal varices. One patient received bypass surgery. This pathology was not a high prevalence in this period of time, but had high morbility. All patients were children, most without risk factors and presented with the disease complications. Most of them repeated complications during the evolution.
Keywords : PORTAIL VEIN-abnormalities; HYPERTENSION, PORTAL; HEMATEMESIS; ESOPHAGEAL AND GASTRIC VARICES; GASTROINTESTINAL HEMORRAGE; SPLENOMEGALY.