Background: EHPVO is an important problem in children. To find out incidence / investigational profile, clinical and therapeutic outcome of children with EHPVO with following study was performed.

Method: The children (<12 years) who were admitted in Pediatric GE ward of PGIMER Chandigarh with history of UGI bleed suggestive of EHPVO from July 1993 to June 2003 were noted. Age / sex / clinical details like Haematemesis / Melaena / Splenomegaly / feature of liver disorder (ascites / jaundice / HE etc) / growth parameters / Neonatal history of umbilical catheterization / sepsis / investigation like USG whole abdomen / LFT / PT / Hemogram / UGI Endoscopy etc were noted.

Results: Out of 50 cases of EHPVO, 30 were male and 20 female. Age was 3 – 12 years (mean 6 years). History of umbilical catherisation / sepsis were present in 6% cases. Fifty out of 50 (100%) came with Haematemesis / 30 (60%) with combined Haematemesis / Melaena. There was no feature of liver failure in any case. USG shows normal hepatic echo texture with 40 cases (80%) having portal cavernoma, 30 (60%) having both portal cavernoma and splenic collateral, 10 (20%) having peri cholecystic collateral. Splenomegaly was present in all cases (100%). There was no colorectal Varix or Hemorrhoid. Gastic varix develop only after EVL / EST of Esophageal varix in 10 (20%) cases. EVL was successfully done 40 (80%) cases but 10 cases (20%) required EST due to technical problem. 5 (10%) cases required distal splenorenal shunt. All patients of EHPVO recovered from portal hypertension but 10 (20%) had growth failure.

Conclusion: EHPVO being important cause of portal hypertension requires urgent management.

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Sujay Chaudhuri

Division of Pediatric Gastroenterology, Department of Gastroenterology, PGIMER Chandigarh