Predisposing Factors in Portal Vein Obstruction in Children

Introduction: The portal vein thrombosis (PVT) is one of the most important causes of portal hypertension among children. The initial clinical manifestation can be represented by upper gastrointestinal bleeding, splenomegaly or ascitis. In children, the most common risk factors of thrombosis in the port system are: neonatal vein catheterization, umbilical cord infections, blood transfusions, sepsis, dehydration, coagulation abnormalities (thrombophilia, antiphospholipid syndrome).

Purpose: The aim of our study was to evaluate the risk factors for PVT in children.

Methods: We have analysed retrospectively all patients who were admitted to our hospital with PVT between January 2012 and May 2017.

Results: During the last 5 years, 40 were admitted to our hospital with PVT. The mean age at the diagnosis was 7.48. The clinical presentation was with upper gastrointestinal bleeding in 20 patients (50%). 31 children (77.5%) were umbilical catheterized immediately after birth. This was the most important risk factor for PVT in our patients. Sepsis in neonatal period were associated in other 11 cases (27.5%). 14 patients were investigated for thrombophilia, 12 (70%) being with factor V Leiden mutation, factor II mutation, deficiency of protein C, protein S or antithrombin III.

Conclusion: The increasing use of umbilical catheterization in our Neonatal Intensive Care Units and especially the use of these catheters for the purpose of administering of any type of medication could be linked with the increased number of cases diagnosed with PVT. The genetic factor certainly plays an important role among these patients. Active ultrasound evaluation of children with risk factor for PVT should be encouraged for an early diagnosis and treatment.