Extrahepatic portal vein morphology in children with extrahepatic portal hypertension assessed by 3-dimensional computed tomographic portography: a new etiology of extrahepatic portal hypertension

• Published in: Journal of pediatric surgery 2006-04, Vol.41 (4), p.812-816
• Main Authors: Shinohara, Tsuyoshi, Ando, Hisami, Watanabe, Yoshio, Seo, Takahiko, Harada, Toru, Kaneko, Kenitiro
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Female; Humans; Hypertension, Portal - diagnostic imaging; Hypertension, Portal - etiology; Hypertension, Portal - pathology; Imaging, Three-Dimensional; Male; Portal Vein - diagnostic imaging; Portal Vein - pathology; Portography - methods; Tomography, X-Ray Computed
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2005.12.027

The cause of extrahepatic portal hypertension in children has not been clarified. Our aim was to determine the morphological features of the extrahepatic portal vein in children with extrahepatic portal hypertension by 3-dimensional computed tomographic portography and to clarify the etiology of this disorder. Six patients ranging in age from 10 to 18 years (median age, 12.8 years) who had portal hypertension presented with hematemesis. They underwent intravenous computed tomographic portography using a helical computed tomography scanner and 3-dimensional image reconstruction. The extrahepatic portal vein was visualized in all patients by 3-dimensional computed tomographic portography. None of the patients showed extrahepatic portal vein obstruction or cavernous transformation. All patients had a tortuous η-shaped extrahepatic portal vein, and a line could be drawn through the flexures of the portal vein to the hepatic hilum. In children, extrahepatic portal hypertension is not caused by extrahepatic portal vein obstruction and may be of embryological origin.