Schettino Graziela C M, Fagundes Eleonora D T, Roquete Mariza L V, Ferreira Alexandre R, Penna Francisco J
Pediatra especialista em Gastroenterologia Pediátrica, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brasil.
J Pediatr (Rio J). 2006 May-Jun;82(3):171-8. doi: 10.2223/JPED.1484.
To review the literature on portal vein thrombosis in children and adolescents, focusing on its diagnosis, complications and treatment.
The medical literature of the past 10 years was reviewed using the PubMed and MEDLINE search engines, with major focus on portal vein thrombosis and its clinical outcomes. The following keywords or expressions were used for the web search: portal vein thrombosis, extra-hepatic portal vein obstruction, prognosis, children, portal hypertension, esophagogastric varices. Additionally, we also reviewed the articles cited in the references of the initially selected papers, as well as relevant textbooks.
Portal vein thrombosis is one of the most common causes of portal hypertension among children. The initial clinical manifestation is characterized either by episodes of upper gastrointestinal bleeding or by splenomegaly on routine clinical examination. The major complications include upper gastrointestinal bleeding, hypersplenism secondary to splenomegaly, growth retardation, and portal biliopathy. The diagnosis is made by abdominal Doppler ultrasonography. Treatment is targeted at the complications and includes primary and secondary prophylaxis against upper gastrointestinal bleeding (which results from the rupture of esophageal varices), and portosystemic shunting in selected cases.
Portal vein thrombosis is one of the major triggers of upper gastrointestinal bleeding in children. Bleeding episodes have a remarkable effect on the quality of life of affected patients. Thus, appropriate diagnosis and treatment are needed in order to reduce morbidity and mortality.
回顾有关儿童和青少年门静脉血栓形成的文献，重点关注其诊断、并发症及治疗。
使用PubMed和MEDLINE搜索引擎检索过去10年的医学文献，主要关注门静脉血栓形成及其临床结局。用于网络搜索的关键词或短语如下：门静脉血栓形成、肝外门静脉阻塞、预后、儿童、门静脉高压、食管胃静脉曲张。此外，我们还查阅了最初选定论文参考文献中引用的文章以及相关教科书。
门静脉血栓形成是儿童门静脉高压最常见的病因之一。最初的临床表现特征为上消化道出血发作或在常规临床检查时出现脾肿大。主要并发症包括上消化道出血、脾肿大继发的脾功能亢进、生长发育迟缓以及门静脉性肝病。通过腹部多普勒超声进行诊断。治疗针对并发症，包括对上消化道出血（由食管静脉曲张破裂所致）的一级和二级预防，以及在特定病例中进行门体分流术。
门静脉血栓形成是儿童上消化道出血的主要诱因之一。出血发作对受影响患者的生活质量有显著影响。因此，需要进行适当的诊断和治疗以降低发病率和死亡率。
