Etiology of portal hypertension among pediatric patient: Hospital based study

There are very few study on etiology of portal hypertension among pediatric patient presenting to tertiary care center in India. Extrahepatic etiology for portal hypertension was attributed as most common cause in previous studies; hence we conducted this study to assess the etiological agent for portal hypertension in pediatric patients attending a tertiary care center at Patna, India.

It was a prospective study conducted under department of pediatrics, Indira Gandhi Institute of Medical Science (IGIMS), Patna over period one year (January 2017-December 2017). Patient less than age of 18 year with portal hypertension were included in the study.

A total of 42 pediatrics patients were enrolled in the study. After all relevant investigation, commonest causes of portal hypertension were: intrahepatic etiology 24 (57.1%); prehepatic etiology 16(38%); posthepatic etiology 2(4.7%). The common causes of intrahepatic etiology in our study were: cryptogenic cirrhosis in 10(23.8%), Wilson's disease in 6 (14.2%), autoimmune hepatitis in 2(4.2%), biliary atresia in 2(4.7%), glycogen storage disease in 1 (2.3%), idiopathic neonatal hepatitis in 1(2.3%) cases. Extra hepatic portal venous obstruction(EHPVO), Budd chiari syndrome were cause of prehepatic and posthepatic etiology respectively. Among children with intrahepatic and prehepatic etiologies, upper gastrointestinal bleeding at presentation was in 44% and 78% respectively.

In our study, most important etiology of portal hypertension among pediatric age group was intrahepatic.