Type:
Educational Exhibit
Keywords:
Paediatric, Cardiovascular system, Gastrointestinal tract, Vascular, Ultrasound, Ultrasound-Colour Doppler, Diagnostic procedure, Embolism / Thrombosis, Not applicable
Authors:
M. P. T. R. Ponte1, R. S. O. D. P. Furtado2, A. I. Gomes3, E. E. Dutenhefner2, R. Lange2, Y. T. Sameshima2, M. R. G. D. Queiroz4; 1SAO PAULO/BR, 2São Paulo/BR, 3Sao Paulo, Sao Paulo/BR, 4São Paulo, SP/BR
DOI:
10.26044/ecr2020/C-04144
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 portal hypertension.
Other thrombogenic factors that require suspicion are vascular compressions caused by anatomical variations like nutcracker syndrome and retroaortic left renal vein.
Diagnosis is given by Doppler ultrasonography (high sensitivity/specificity), with no radiation exposure/sedation.
One should look for intraluminal echogenic material, decrease or no flow on Doppler study, in addition to surrounding vascular neoformation.