Sarin SK(1), Agarwal SR. Extrahepatic portal vein obstruction (EHPVO) is an important cause of noncirrhotic portal hypertension, especially in Third World. Endoscopic Management. S. K. Sarin, Cyriac Abby Philips, Rajeev Khanna tal vein obstruction (EHPVO), noncirrhotic portal fibrosis. (NCPF; or idiopathic PHT. Extrahepatic Portal Vein Obstruction (EHPVO). Non‐Cirrhotic Shiv Kumar Sarin MD, DM. Director Treatment of chronic EHPVO in children.
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Besides correcting portal hypertension, it also abolishes the systemic manifestations of EHPVO such as normalization of coagulation parameters,11 improved liver function  and linear growth.
Endoscopic sclerotherapy in children. Gastrointestinal bleeding in children. Natural history is defined by episodes of variceal bleed and symptoms related to enlarged spleen.
Endosonographic evaluation of the rectum ehpvi children with extrahepatic portal venous obstruction. Indeed, EVL has become the preferred mode of treatment of variceal bleeding in adults. These findings suggest diminished anabolic action of growth hormone on muscle growth affecting the lean muscle mass, and its lipolytic effect resulting in saein adiposity.
Variceal bleed and splenomegaly are the commonest presentations. Fifteen-year follow up of endoscopic injection sclerotherapy in children with extrahepatic portal venous obstruction.
Surgical guidelines for the management of extra-hepatic portal vein obstruction. Diagnostic upper GI endoscopy for hematemesis in children: Extrahepatic portal venous obstruction EHPVO is the commonest cause of portal hypertension and variceal bleeding in children.
The natural history of portal hypertensive gastropathy: Endoscopic ligation compared with sclerotherapy for bleeding esophageal varices in children with extrahepatic portal venous obstruction. The low prevalence in pediatric studies clearly suggests that the duration of portal hypertension plays an important role in the development of rectal varices.
Extrahepatic portal venous obstruction and obstructive jaundice: The latter mechanism has been further substantiated by the fact that after conventional shunt surgery the levels of anticoagulant proteins tend to further go down.
Management of gastric varices and portal hypertensive gastropathy. Variceal recurrence was low in both the groups 6.
Management of extra hepatic portal venous obstruction (EHPVO): current strategies
Although the liver may appear normal, functional compromise develops in the long term. Aetiology and management of extrahepatic portal vein obstruction in children: Studies in children have shown that hereditary or acquired coagulation disorders do not play a role in the pathogenesis of EHPVO in children.
The effect of increased portal pressure in EHPVO is not localized to the esophagus and stomach; it affects the entire gastrointestinal tract. Endoscopic band ligation followed by sclerotherapy: In a study of five cases, Dhiman et al [49 ] showed that repeat ERCP done after weeks of shunt surgery demonstrated total disappearance of cholangiographic changes in one, partial disappearance in two and no change in remaining two cases.
There is no controversy about the management of acute variceal srain. Portal hypertension in north Indian children.
Idiopathic portal hypertension and extrahepatic portal venous obstruction.
Mesoportal bypass for extrahepatic portal vein obstruction in children: Portal hypertensive gastropathy in children with extrahepatic portal venous obstruction: Magnetic resonance MR imaging with intravenous gadolinium injection delineate the cavernoma and biliary changes simultaneously and may be extremely useful in children.
Endoscopic sclerotherapy for esophageal varices in children with extrahepatic portal vein obstruction; a follow -up study. Besides variceal bleeding, which is the commonest presentation, patients may have symptomatic portal biliopathy, hypersplenism, and growth retardation. Unfortunately, the experience of EVL in children is limited.
Consensus on extra-hepatic portal vein obstruction.
Natural history of bleeding after esophageal variceal eradication in patients with extrahepatic portal venous obstruction; a year follow-up. Factor V Leiden and prothrombin gene GA mutations are uncommon in portal vein thrombosis in India. Eupvo hypertensive gastropathy PHG: Primary biliary tract surgery has significant morbidity and mortality due to extensive collaterals around the bile ducts. Portal hypertensive gastropathy and gastric varices before esophageal variceal sclerotherapy and after obliteration.
Poddar U Borkar Sagin. Growth impairment in children with extrahepatic portal vein obstruction is improved by mesenterico-left portal vein bypass.
Cholestasis in children with portal vein obstruction. On the other hand, EVL has the advantages of rapid eradication of varices requiring fewer sessions and portending fewer complications.
Endoscopic band ligation followed by sclerotherapy. The prevalence and spectrum of colonic lesions in patients with cirrhosis and noncirrhotic portal hypertension. Results of surgical portosystemic shunts.
Consensus on extra-hepatic portal vein obstruction.
Prevalence, classification and natural history of gastric varices: In patients with endoscopic failure, a staged procedure portosystemic shunt followed by biliary surgery should be preferred. This has been substantiated in other studies in children. Surgical restoration of portal flow corrects procoagulant and anticoagulant deficiencies eh;vo with extrahepatic portal vein thrombosis.
The etiology and clinical presentation are different in children and adults. Variceal bleeding in EHPVO can be successfully managed by endoscopic ehlvo of varices, which has sarkn morbidity but requires repeated visits, or by portosystemic shunt surgery, which provides good control of bleeding, possibly helps growth retardation, hypersplenism, and protects against future development of portal biliopathy but is associated with surgical mortality and is sometimes not feasible due to nonavailability of a satisfactory vessel.
Improvement of growth after restoration of hepatic blood flow with mesenteric-left-portal bypass or Rex shunt, has been documented.