Portal-vein obstruction in children leads to growth retardation

Sarin, Shiv Kumar; Bansal, Anupam; Sasan, Shailja; Aruna, N

doi:10.1002/hep.1840150210

Cited by 104 publications

(92 citation statements)

References 19 publications

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“…16 Investigations included routine hemogram, peripheral smear for anemia type, reticulocyte count, tests for liver function (including alanine transaminase, aspartate transaminase, serum bilirubin, and alkaline phosphatase), blood sugar, serum cholesterol, and triglyceride estimations. An ultrasound examination was performed after a n overnight fast using a Sonoline 5'-2 (Siemens Ltd., Erlangen, Germany) 3.5 mHz sector scanner.…”

Section: Methodssupporting

confidence: 90%

High familial prevalence of gallstones in the first-degree relatives of gallstone patients

et al. 1995

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Limited information is available on the prevalence of gallstones in the first-degree relatives of gallstone patients. Three groups of subjects were studied by real-time ultrasound examination: group A, 105 index gallstone patients (male/female; 20:85); group B, 330 first-degree relatives of index patients; group C, matched controls for group A (n = 105) and group B (n = 330) subjects. Dietary, anthropometric, and biochemical investigations were carried out. In 39 of 105 (37%) index cases, one or more additional family members had gallstones (positive-index case). The positive-index cases were younger than the remaining index cases (mean age, 33.1 +/- 14 vs. 44.5 +/- 13.1 years; P < .05). Fifty-one of 330 (15.5%) first-degree relatives had gallstones, nearly four and a half times (95% confidence interval [CI], 2.4 to 8.5) more often than in the matched control population (12 of 330 [3.6%]). Thirty-three of 51 (65%) positive relatives were women; mother (37.3%), sister (17.6%) or daughters (10%) to the index patients. There was no difference in the diet, physical activity, and serum lipid profile between the positive index patients and the remaining gallstone patients and positive relatives and their controls. Our results show that there is a strong familial predisposition for gallstone formation. Female relatives of young gallstone patients should be routinely screened for gallstones.

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Section: Methodssupporting

confidence: 90%

High familial prevalence of gallstones in the first-degree relatives of gallstone patients

et al. 1995

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“…These children may not grow as fast as their siblings. 6 The experience with conservative management in India has been disastrous; when one surgeon attempted to trace 25 children with EHO who had refused operation 5 years previously, all of them had died.7 Thus, active intervention is probably more appropriate. There is little experience with the use of f-blocking drugs8 in EHO, and the main choice lies between EST and portosystemic shunt surgery.…”

Section: Discussionmentioning

confidence: 99%

Proximal Splenorenal Shunts for Extrahepatic Portal Venous Obstruction in Children

et al. 1994

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ObjectiveThe results of proximal splenorenal shunts done in children with extrahepatic portal venous obstruction were evaluated. Summary Background DataExtrahepatic portal venous obstruction, a common cause of portal hypertension in children in India, is being treated increasingly by endoscopic sclerotherapy instead of by proximal splenorenal shunt. It is believed that surgery (or the operation) carries high mortality and rebleeding rates and is followed by portosystemic encephalopathy and postsplenectomy sepsis. However, a proximal splenorenal shunt is a definitive procedure that may be more suitable for children, particularly those who have limited access to medical facilities and safe blood transfusion. MethodsBetween 1976 and 1992, the authors performed 160 splenorenal shunts in children. Twenty were emergency procedures for uncontrollable bleeding and 140 were elective procedures -102 for recurrent bleeding and 38 for hypersplenism. ResultsThe overall operative mortality rate was 1 .9%-10% (3/160-2/20) after emergency operations and 0.7% (1/140) after elective operations. Rebleeding occurred in 17 patients (1 1% ConclusionsA proximal splenorenal shunt, a one-time procedure with a low mortality rate and good long-term results, is an effective treatment for children in India with extrahepatic portal venous obstruction.Extrahepatic portal venous obstruction (EHO), the main reasons for this change are that EST is easy to permost common cause of upper gastrointestinal hemor-form, atraumatic, and effective in preventing bleeding, rhage in children,'"2 is being treated increasingly by en-once the esophageal varices are obliterated. Surgery is fadoscopic sclerotherapy (EST) instead of by surgery. The vored less because it is thought to be accompanied by 193

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“…Sarin et al had reported in a prospective study of 61 children with EHPVO, a reduction in incremental growth velocity and short stature was observed in about 50% of patients compared with healthy control. 6 Reduced portal blood supply to the liver and deprivation of hepatotrophic hormones regulating liver growth and function are probable responsible for it. They hypothesized that deprivation of portal blood leads to growth retardation is further supported by the fact that children who had more prolonged portal vein thrombosis had more marked growth retardation.…”

Section: Resultsmentioning

confidence: 99%

A study on demographic and clinical profile of children with extra hepatic portal venous obstruction and with special reference to thrombophilic factors

Jena

Mohanty

Patra

et al. 2017

Int J Community Med Public Health

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Background: Extra-hepatic portal vein obstruction (EHPVO) due to portal vein thrombosis is an important cause of portal hypertension in several region including India. The cause of thrombosis in these patients remains unclear. Objective of the study was to study the demographic features, etiology, clinical, laboratory findings with special reference to thrombophilic factors like protein C, protein S and antithrombin III deficiency in children with EHPVO.Methods: The prospective analysis of 62 patients of EHPVO (<14 years of age) was done in the Department of Hepatology, SCB medical College, Cuttack. After detailed history, clinical examination, Ultrasound abdomen /color Doppler and Upper GI endoscopy, the subjects were analyzed for any deficiency of thrombophilic factors like protein C, protein S and antithrombin III.Results: A total of 62 patients (37 Male, 25 Female) with mean age of 8.3+3.1 years were studied. Growth retardation was present in the form of wasting (alone) 20.9%, stunting (alone) 25.8% and both wasting and stunting was found in 9.8% cases. History of neonatal, umbilical sepsis and umbilical vein catheterization was found in 15.9% and 10.2% of cases respectively. Haemorrhage from oesophageal varices was prevalent symptoms in 85.9% patients. Splenomegaly was found in 91.9% patients and ascites in 9.4% patients. 47 patients studied for protein C, S and antithromibin III. 14 patients were found to have thrombophilia: protein C deficiency in 9, protein S deficiency in 8, Antithrombin III deficiency in 6.Conclusions: The etiology of EHPVO in the majority of patients remain still unclear. It is commonly associated impaired somatic growth. The risk of EHPVO increases in the presence of thrombophilia, resulting from deficiency of naturally occurring anticoagulant proteins like Protein C, Protein S and Antithrombin III.

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Portal-vein obstruction in children leads to growth retardation

Cited by 104 publications

References 19 publications

High familial prevalence of gallstones in the first-degree relatives of gallstone patients

High familial prevalence of gallstones in the first-degree relatives of gallstone patients

Proximal Splenorenal Shunts for Extrahepatic Portal Venous Obstruction in Children

A study on demographic and clinical profile of children with extra hepatic portal venous obstruction and with special reference to thrombophilic factors

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