Study of portal hypertension in young age [below 15 years-old]

ABSTRACT

During the period from January 1990 to June 1992, 26 young patients were diagnosed as having portal hypertension, their ages ranged between 2 and 15 years. Bilharzial hepatic fibrosis represented the etiology in 38.5% of cases, following by post- hepatic cirrhosis in 30.7%, non-Hodgkin's lymphoma and portal vein thrombosis [11.5% for each], and lastly congenital hepatic fibrosis with an incidence of 7.7%. Symptoms included hematemesis and abdominal enlargement as the commonest presentations. Signs included splenomegaly in 77% of patients, ascites in 46.1% and jaundice in 38%. Investigation included blood picture, liver function tests, hepatitis B-surface antigen, abdominal sonography, liver biopsy, Doppler ultrasound, splenoportography, proctosigmoidoscopy with fresh mucosal biopsy for B-ova detect, and endoscopic upper GI examination. Portal vein dilatation was present in all, but 3 cases, and esophageal varices were detected in 80%. Treatment strategies included conservative, endoscopic and surgical lines. Esophageal sclerotherapy was done safely with a success rate of 76.5%