Learning objectives
To propose a practical approach of pathologic conditions and different sites of abdominal vascular thrombosis.
To sum up the main sonographic features associated or not with catheters.
Background
Pediatric abdominal thrombosis may lead to great disability or death. It is related to multiple risk factors, such as catheterization, inflammatory conditions, immobilization, dehydration, thrombophilia, congenital heart disease; or it may be, though rare, idiopathic. The portal vein is the commonest site of thrombosis because umbilical catheterization association and is the second most common site of no–catheter-related abdominal venous thrombosis. Other common sites without catheterization association are renal and hepatic veins. In children, extrahepatic portal venous obstruction is one of the most important causes of...
Findings and procedure details
As in adults, the most common sites of childhood thrombosis are the deep venous system of the lower limbs and pulmonary arteries and its branches. Thus, abdominal vessels thrombosis (AVT) is a rare entity. On the other hand, one should be able to diagnose it mainly because of its high morbidity.
The abdominal vessels thrombosis may be a consequence of an underlying prothrombotic disorder, or secondary to the use of vascular catheters in hospitalized, which explains why it usually carries a poorer prognosis than the...
Conclusion
Vascular thrombosis in pediatric patients present as a morbid condition. In clinical suspicion or the presence of risk factors, especially vascular catheterization, an investigation should be performed. In this context, abdominal Doppler ultrasonography is presented as a reliable and safe method, being the primary and most accessible option. Knowledge of the presentation and ultrasound characteristics of infantile abdominal thromboses, as well as the particularity of neonatal circulation, is extremely important to reduce negative outcomes of this condition.
Personal information and conflict of interest
R. S. O. D. P. Furtado; Sao Paulo, SAO PAULO/BR - nothing to disclose M. P. T. R. Ponte; Sao Paulo/BR - nothing to disclose A. I. Gomes; Sao Paulo, SAO PAULO/BR - nothing to disclose E. E. Dutenhefner; Sao Paulo, SAO PAULO/BR - nothing to disclose Y. T. Sameshima; Sao Paulo/BR - nothing to disclose M. R. G. D. Queiroz; Sao Paulo/BR - nothing to disclose R. Lange; Sao Paulo/BR - nothing to disclose
References
FERRI, Priscila Menezes et al.Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center.Arq. Gastroenterol.[online]. 2012, vol.49, n.1 [cited 2020-01-11], pp.69-76.
Non–Catheter-related Venous Thromboembolism in Children: Imaging Review from Head to ToeMougnyan Cox,Monica Epelman,Tushar Chandra,Arthur B. Meyers,Craig M. Johnson,Daniel J. Podberesky. RadioGraphics 2017; 37:1753–1774 Neonatal Abdominal Aortic Thrombus: An Associated Risk of Umbilical Artery Catheterization Melissa Langan, AS, AAS, RDMS, RVT1Journal of Diagnostic Medical Sonography 2015, Vol. 31(5) 322–326