Four cases of portal hypertension in children due to portal vein thrombosis are presented.
All had splenomegaly, hypersplenism and esophageal varies which bled prior to admission. Age varied´ between 5 and 11 years of age.
Diagnosis was established by spleneoportography, liver biopsy and operative findings as well as blood pictures.
All cases were subjected to splenctomy and spleno-renal shunt under hypothermia with no mortality. Two patients, aged 5 and 8, received central type spleno-renal shunt (Clatworthy, 1959) due to small size of spIenic vein at the amputated end.
Natural course of the disease, in general, is reviewed in detail, and proposed treatment according to the stage of the progression of the disease leading up to the definitive treatment is discussed. A plea is entered not to perform splenectomy alone in those children, unless one is prepared to perform effective portal decompressive measure, such as spleno-renal shunt, at the same time.
|