Original articleClinical endoscopyPrevalence, nature, and predictors of colonic changes in children with extrahepatic portal vein obstruction
Graphical abstract
Section snippets
Methods
Children (≤18 years) with EHPVO were prospectively enrolled either at diagnosis or during follow-up. Diagnosis of EHPVO was based on consensus guidelines of the Asian Pacific Association for the Study of Liver.12 Children who were on beta-blockers, had previous surgery for PHT (portosystemic shunt, splenectomy, or devascularization), had coexisting chronic liver disease, or who refused to participate were excluded. Disease duration was calculated from the time of first detection of splenomegaly
Results
Fifty-four EHPVO children (41 boys; median age at enrollment, 12 years [IQR, 8-15]; median duration of symptoms before diagnosis, 5 years [IQR, 3.5-7.9]) were evaluated. Most children (n = 46; 85%) had presented with hematemesis and the remaining with splenomegaly. Fifty-two children were on endotherapy (EVL or EST); 46 patients were post variceal bleed and 6 were on prophylactic EVL. Most patients (93%; n = 50) were enrolled in follow-up while on endotherapy, and only 4 children were enrolled
Discussion
We found RVs in 94% and PHC in 74% of our EHPVO children. Colonic varices were uncommon (3.7%), and 16% had ileal changes. In patients with colopathy, colitis-like changes were more common than vascular lesions, and the left side of the colon was involved more often than the right side. PHC patients were more likely to have PHG and increased number of endotherapy sessions (EVL/EST) with eradicated varices. We have described a new finding of punched-out ulcers in 6 patients (15%). Bleeding per
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DISCLOSURE: All authors disclosed no financial relationships.