Portal vein thrombosis in the neonate: Risk factors, course, and outcome - 10/08/11
, Monica Epelman, MD, Alan Daneman, MD, Rahim Moineddin, PhD, Boriana Parvez, MD, FAAP, FRCPC, Tal Shechter, MD, Jonathan Hellmann, MD, FRCPC
Reprint requests: Iris Morag, MD, Clinical Fellow, Division of Neonatology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, Ontario, Canada M5G 1XBRésumé |
Objective |
To determine the risk factors, clinical features, and outcome of infants diagnosed with portal vein thrombosis (PVT).
Study design |
A retrospective chart review was conducted of all consecutive infants admitted to the Hospital for Sick Children, Toronto, between January 1999 and December 2003 diagnosed with PVT.
Results |
PVT was diagnosed in 133 infants, all but 5 of whom were neonates, with a median age at time of diagnosis of 7 days. An umbilical venous catheter (UVC) was inserted in 73% of the infants and was in an appropriate position in 46% of them. Poor outcome, defined as portal hypertension or lobar atrophy, was diagnosed in 27% of the infants and was significantly more common in those with an initial diagnosis of grade 3 PVT and in those with a low or intrahepatically placed UVC. Anticoagulation treatment did not appear to have a significant effect on outcome.
Conclusions |
PVT occurs early in life; major risk factors in addition to the neonatal period are placement of UVC and severe neonatal sickness. Poor outcome is associated with an improperly placed UVC and with grade 3 thrombus.
Le texte complet de cet article est disponible en PDF.Abbreviations : CHD, NICU, PHTN, PVT, TE, USG, UVC, VTE
Plan
| Iris Morag was responsible for analyzing the results and writing the manuscript. Monica Epelman planned the research, collected the data, and analyzed the radiologic results. Alan Daneman planned, conducted, and interpreted findings of the radiologic aspect of this research. Rahim Moineddin conducted the statistical analyses. Boriana Parvez planned and conducted the clinical component of the research. Tal Schechter, as part of the thrombosis team in our institute, helped collect and analyze the hematologic data. Jonathan Hellmann played an active role in analyzing the data and writing the manuscript. No conflicts of interest or financial assistance were associated with this research. |
Vol 148 - N° 6
P. 735-739 - juin 2006 Retour au numéro
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