Portal hypertension with thrombosis and cavernous transformation of the portal vein in a 17-year-old patient after splenectomy

Abstract

Portal hypertension is a rare condition in children and adolescents and may be caused by development of cavernous transformation of the portal vein. A 17-year-old patient was admitted to the clinic following the development of symptoms suggesting bleeding from the gastrointestinal tract. Endoscopic examination of the upper gastrointestinal tract showed oesophageal varices. Imaging studies revealed an occlusion and cavernous transformation of the portal vein. The whole clinical picture suggested that thrombosis and cavernous transformation of the portal venous system after splenectomy for haematological disease (idiopathic thrombocytopenic purpura) could be a cause of the portal hypertension in our patient. The aim of this study was to report the case of a patient with thrombosis and cavernous transformation of the portal vein as a complication requiring splenectomy. Paediatric patients after splenectomy should be under systematic control, even in the case of asymptomatic clinical features. In this group of patients abdominal ultrasound should be considered in the diagnosis and follow-up of post-splenectomy portal vein thrombosis and development of portal hypertension.