Etiology and prognosis of portal hypertension in children of northwest Iran

Abstract

Background: Portal hypertension refers to the pathological increase in portal pressure or pressure gradient difference between the portal vein and lower vena cava. This study aimed to determine the etiology and prognosis of portal hypertension in children of northwest Iran for ten years. Methods: In this descriptive cross-sectional survey, 73 children under the age of 18 years with portal hypertension who were admitted to the Gastroenterology department of Tabriz Children Hospital for ten years were studied. These children were evaluated for demographic data as well as the underlying etiology according to the liver biopsy, abdominal ultrasound, and liver Doppler ultrasound records. Results: The most common cause of portal hypertension was cryptogenic cirrhosis with a frequency of 21 (28.8%). Out of the total number of patients, 7 deaths (9.7%) were observed whereas 84.7% of patients had successful treatment and were discharged without complications. Two patients underwent portosystemic shunt surgery. Liver transplantation was done for 2 cases. Sclerotherapy was performed for 35 patients (48.6%). Out of this group of patients 28 cases (80%) had a good response to sclerotherapy, 4 cases (11.4%) died, two were referred for portosystemic shunt, and one patient underwent liver transplantation. Conclusion: The etiologic factors leading to portal hypertension have a wide diversity in terms of underlying disease and prognosis. A thorough assessment of the cause of portal hypertension is important for making the best therapeutic decision. Early diagnosis has a critical role in improving response to therapy and preventing complications.

Keywords

• portal hypertension
• cirrhosis
• splenomegaly
• gastrointestinal bleeding
• children