Correlation of endoscopic findings with Doppler
ultrasound in portal hypertension in children

Swati Singh; Rasika Bhamre; Naman Shetty; Himali Meshram; Saumil Shah; Ira Shah

doi:10.5114/ceh.2021.106509

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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abstract:

Original paper

Correlation of endoscopic findings with Doppler ultrasound in portal hypertension in children

Swati Singh

¹

,

Rasika Bhamre

¹

,

Naman Shetty

¹

,

Himali Meshram

¹

,

Saumil Shah

¹

,

Ira Shah

¹

Department of Pediatric Gastroenterolgy and Hepatology, Bai Jerbai Wadia Hospital of Children, Mumbai, India

Clin Exp HEPATOL 2021; 7, 2: 191-195

DOI: https://doi.org/10.5114/ceh.2021.106509

Online publish date: 2021/05/28

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Introduction
To determine the correlation of the endoscopic findings with portal Doppler and ultrasound (USG) in children with suspected portal hypertension (PHT).

Material and methods
Eighty children with extrahepatic portal vein obstruction (EHPVO) and chronic liver disease (CLD) were included in this retrospective study conducted over a period of 1 year. All patients underwent upper gastrointestinal (GI) endoscopy and Doppler.

Results
The etiology was EHPVO in 30 (37.5%) patients, biliary atresia in 12 (15%), Budd-Chiari syndrome in 11 (13.7%), Wilson’s disease in 10 (12.5%), idiopathic CLD in 8 (10%), autoimmune hepatitis in 4 (5%), glycogen storage disease (GSD) in 3 (3.8%), non-alcoholic liver disease (NAFLD) in 1 (1.3%) and systemic lupus erythematosus (SLE) in 1 (1.3%) patient. Fifty-three (66.25%) patients had esophageal varices on endoscopy, of whom 3 (3.8%) had associated gastric varices. Portal hypertensive gastropathy (PHG) was present in 30 (37.5%) patients, of whom 10 (12.5%) had severe PHG. Forty-one (51.3%) patients had PHT on Doppler (k correlation 0.43). Kappa correlation was 0.43 in patients with biliary atresia, 0.31 in Budd-Chiari syndrome, 0.23 in idiopathic CLD, 0.21 in CLD, and 0.05 in Wilson’s disease. All (100%) EHPVO patients and 39 (78%) CLD patients had PHT on USG. Endoscopic findings of PHT were seen in 24 (80%) EHPVO patients and 29 (58%) CLD patients. All patients with EHPVO had cavernous transformation of the portal vein on Doppler. For patients with CLD, the common Doppler findings were collaterals seen in 35 patients and reversal of flow in 12 patients.

Conclusions
Doppler ultrasound followed by endoscopy should be used to diagnose PHT in children. In children with biliary atresia, Doppler ultrasound may miss changes of PHT.

keywords:

Correlation of endoscopic findings with Doppler ultrasound in portal hypertension in children

Swati Singh 1 , Rasika Bhamre 1 , Naman Shetty 1 , Himali Meshram 1 , Saumil Shah 1 , Ira Shah 1

children, PHT, EHPVO, upper endoscopy, CLD

Swati Singh

¹

,

Rasika Bhamre

¹

,

Naman Shetty

¹

,

Himali Meshram

¹

,

Saumil Shah

¹

,

Ira Shah

¹