RESUMO
Introduction: Budd-Chiari syndrome (BCS) is rare in children. Underlying etiologies, natural history and management differ in children and adults. Treatment options like liver transplantation and transjugular intrahepatic portosystemic shunt have also been less well-studied in children. Presented here is the case of a male child with BCS after coronavirus disease 2019 (COVID-19) infection. Case presentation: A 3-year-old male child presented with complaints of gradually increasing abdominal distension, constipation, decreased urine output, visible veins over abdomen and swelling in lower limbs and periorbital edema since last 15 days. He was diagnosed as BCS after multiple imaging investigations, including triple phase contrast-enhanced computed tomography (CECT) abdomen. His COVID antibody tested positive. Conclusion: Practice guidelines for children with BCS should be formulated, expert group recommendations should be reviewed and a consensus statement should be issued. Underlying etiology remains obscure despite extensive work-up in most of the children. Association of COVID-19 with BCS may be incidental but should be studied further as COVID is known to cause thrombotic complications
RESUMO
Las enfermedades tromboembólicas han sido denominadas la nueva epidemia de los hospitales pediátricos del tercer nivel de atención. Son más evidentes en los pacientes cardíacos y cardioquirúrgicos que en ningún otro tipo de enfermos. Los niños tratados por cardiopatía estructural desarrollan trombosis iatrogénicamente, con frecuencia, precipitada por un catéter venoso central. El sistema de la hemostasia no está completamente desarrollado hasta los 6 meses de vida. Hay importantes diferencias fisiológicas en el sistema hemostático de los niños comparado con el de los adultos. Las complicaciones trombóticas en niños son habitualmente eventos secundarios asociados a patologías subyacentes. La incidencia global de eventos tromboembólicos en niños está aumentando, se estima que oscila entre 0,07 y 28,8 casos por cada 10.000 admisiones pediátricas en general. Este artículo revisa determinados procesos mórbidos pediátricos, los agentes antitrombóticos administrados con más frecuencia a la población pediátrica y la evidencia científica disponible para la prevención ante diferentes situaciones clínicas.(AU)
Tromboembolic disease has been termed the new epidemic of pediatric tertiary care hospitals. This is more evident in cardiac and cardiac surgical patients than in any other type of patients. Children treated for congenital structural cardiac disease develop iatrogenic thrombosis, most commonly precipitated by central venous access. The hemostatic system is not fully mature by 6 months of age. There are important physiologic differences in the hemostatic system in children compared with adults. Thrombotic complications, when they occur in children, are usually secondary events related to serious underlying disorders. The overall incidence of venous thromboembolism events in children is increasing, with estimates ranging from 0.07 to 28.8 per 10,000 in general pediatric admissions. This article reviews a number of specific pediatric cardiac conditions, the common antithrombotic agents used in pediatrics, and the current evidence for prevention in different clinical situations(AU)