Profile of extrahepatic portal venous obstruction among children in Central India.

INTRODUCTION

There is a paucity of data regarding the clinical profile of children with extrahepatic portal venous obstruction (EHPVO) from Central India.

MATERIAL AND METHODS

Retrospective analysis of 30 children with EHPVO treated between 2002 and 2012.

RESULTS

The median age of presentation was 12.5 years (range 5-14 years) and median duration of symptoms was 3.2 years (range 0.3-10 years). Home delivery was noted in 30 cases (100%), umbilical sepsis in 8 (27%) and history of cow dung application over the umbilical cord in 2 cases (6.7%). Twenty-two cases (73.4%) presented with upper gastrointestinal (GI) bleeding while 18 (60%) were referred for pancytopenia and/or hypersplenism. The patients underwent a median of 3.2 sessions of endoscopic therapy for varices. Most patients (19/30, 63.4%) dropped out of serial endotherapy due to the paucity of funds. Shunt surgery was performed in 7 patients.

CONCLUSIONS

Home delivery and umbilical sepsis are significant risk factors for EHPVO. Most patients present with GI bleeding and do well on endoscopic treatment/shunt surgery.