Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Portal Hypertension of a Delayed Onset Following Liver Abscesses in a 12-Month-Old Infant: A Case Report and Review of the Literature

  • Received : 2018.02.11
  • Accepted : 2018.05.27
  • Published : 2019.07.15
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Abstract

We report a 12-month-old female infant who had a history of neonatal sepsis with liver micro-abscesses that resolved with intravenous antibiotics during neonatal period. During her neonatal admission period, no umbilical vein catheter was inserted. Also, she did not undergo any abdominal surgeries or had a postnatal history of necrotizing enterocolitis. However, the child developed upper gastrointestinal bleeding in form of hematemesis and melena secondary to esophageal varices at the age of 12 months with an extra-hepatic portal vein obstruction with cavernous transformation and portal hypertension subsequently. The child underwent a successful endoscopic injection sclerotherapy. She is now 20-month-old and has portal hypertension but otherwise asymptomatic. We are proposing the possibility of a delayed-onset portal hypertension as a complication of liver abscess and neonatal sepsis.

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References

  1. Garel D, Wood C, Pariente D, Dommergues JP. Portal system obstruction of delayed onset following neonatal Staphylococcus aureus infection. Arch Fr Pediatr 1989;46:41-3.
  2. Vade A, Sajous C, Anderson B, Challapalli M. Neonatal hepatic abscess. Comput Med Imaging Graph 1998;22:357-9. https://doi.org/10.1016/S0895-6111(98)00033-0
  3. Sethi SK, Dewan P, Faridi MM, Aggarwal A, Upreti L. Liver abscess, portal vein thrombosis and cavernoma formation following umbilical vein catherisation in two neonates. Trop Gastroenterol 2007;28:79-80.
  4. Shah I, Bhatnagar S. Liver abscess in a newborn leading to portal vein thrombosis. Indian J Pediatr 2009;76:1268-9. https://doi.org/10.1007/s12098-009-0244-5
  5. Sherwani P, Vire A, Anand R, Jajoo M. Umbilical venous catheterization gone wrong: hepatic complications. Indian J Radiol Imaging 2016;26:40-3. https://doi.org/10.4103/0971-3026.178287
  6. Aggarwal S, Mathur NB, Garg A. Portal vein thrombosis complicating neonatal hepatic abscess. Indian Pediatr 2003;40:997-1001.
  7. Tan NW, Sriram B, Tan-Kendrick AP, Rajadurai VS. Neonatal hepatic abscess in preterm infants: a rare entity? Ann Acad Med Singapore 2005;34:558-64.
  8. Doerr CA, Demmler GJ, Garcia-Prats JA, Brandt ML. Solitary pyogenic liver abscess in neonates: report of three cases and review of the literature. Pediatr Infect Dis J 1994;13:64-9. https://doi.org/10.1097/00006454-199401000-00014
  9. Chawla YK, Bodh V. Portal vein thrombosis. J Clin Exp Hepatol 2015;5:22-40. https://doi.org/10.1016/j.jceh.2014.12.008
  10. Poddar U, Thapa BR, Rao KL, Singh K. Etiological spectrum of esophageal varices due to portal hypertension in Indian children: is it different from the West? J Gastroenterol Hepatol 2008;23:1354-7. https://doi.org/10.1111/j.1440-1746.2007.05102.x
  11. Valla DC, Condat B, Lebrec D. Spectrum of portal vein thrombosis in the West. J Gastroenterol Hepatol 2002;17 Suppl 3:S224-7. https://doi.org/10.1046/j.1440-1746.17.s3.4.x
  12. Rangari M, Gupta R, Jain M, Malhotra V, Sarin SK. Hepatic dysfunction in patients with extrahepatic portal venous obstruction. Liver Int 2003;23:434-9. https://doi.org/10.1111/j.1478-3231.2003.00879.x
  13. Arora NK, Lodha R, Gulati S, Gupta AK, Mathur P, Joshi MS, et al. Portal hypertension in north Indian children. Indian J Pediatr 1998;65:585-91. https://doi.org/10.1007/BF02730901
  14. El-Karaksy HM, El-Koofy N, Mohsen N, Helmy H, Nabil N, El-Shabrawi M. Extrahepatic portal vein obstruction in Egyptian children. J Pediatr Gastroenterol Nutr 2015;60:105-9. https://doi.org/10.1097/MPG.0000000000000548
  15. Blei AT, Groszmann RJ. Vasopressin and Vasoconstrictors. In: Shepherd AP, Granger DN, eds. The Physiology of the Intestinal Microcirculation. New York (NY): Raven Press, 1984:377.
  16. Bloom SR, Polak JM. Somatostatin. Br Med J (Clin Res Ed) 1987;295:288-90. https://doi.org/10.1136/bmj.295.6593.288
  17. Imperiale TF, Teran JC, McCullough AJ. A meta-analysis of somatostatin versus vasopressin in the management of acute esophageal variceal hemorrhage. Gastroenterology 1995;109:1289-94. https://doi.org/10.1016/0016-5085(95)90590-1
  18. Zargar SA, Javid G, Khan BA, Yattoo GN, Shah AH, Gulzar GM, et al. Endoscopic ligation compared with sclerotherapy for bleeding esophageal varices in children with extrahepatic portal venous obstruction. Hepatology 2002;36:666-72. https://doi.org/10.1053/jhep.2002.35278
  19. Kim SJ, Kim KM. Recent trends in the endoscopic management of variceal bleeding in children. Pediatr Gastroenterol Hepatol Nutr 2013;16:1-9. https://doi.org/10.5223/pghn.2013.16.1.1
  20. Bari K, Garcia-Tsao G. Treatment of portal hypertension. World J Gastroenterol 2012;18:1166-75. https://doi.org/10.3748/wjg.v18.i11.1166