1Assistant Professor, Department of Pediatrics, SRM Medical College & Hospital, Tamil Nadu
2Assistant Professor, Department of Gastroenterology, ICH & HC, Egnore
3HOD, Department of Pediatric Gastroenterology, ICH & HC, Egnore
*Corresponding Author: Email: karthik.dch@gmail.com
Online published on 3 March, 2016.
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 retardationand portal biliopathy.
To study the bleeding and non-bleeding manifestations in South Indian children with EHPVO.
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.
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).
Chi square test, Student t test.
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%).
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.
EHPVO, Non-bleeding manifestations
