A STUDY ON CLINICO-LABORATORY PROFILE IN CHILDREN WITH EXTRA HEPATIC PORTAL VENOUS OBSTRUCTION.

EHPVO is a common cause of portal hypertension in children. Umbilical sepsis, umbilical vein catheterization, history of NICU admissions, dehydration and abnormal thrombophilic parameters are common etiological causes with most common presentation as hematemesis followed by splenomegaly. Objective: To study clinical profile and laboratory features at presentation in children with EHPVO. Method: Children with clinical profiles suggestive of EHPVO like upper GI bleeding and abdominal lump attending the pediatric OPD, and specialty OPD and admitted in wards were enlisted. A detailed history was taken to find out the risk factors causing EHPVO. Clinical examination and anthropometric evaluation of the cases were recorded. Complete hemogram, anemia profile, liver function tests, levels of thrombophilic factors like protein C and S, antithrombin III, and factor V were done. Result: Among 50 participants, 27 (52.9%) were males and 23 (47.1%) were females and the mean age group being 8.09 ± 3.09 years. Hematemesis (92.20%) and splenomegaly (90.20%) were the most common clinical features and growth retardation was seen in 64% of cases. Anemia was found in all the cases, Leukopenia (45.1%), thrombocytopenia (82.4%), and folate dediciencies (15.7%). Deranged SGOT, ALP and PT-INR were observed in 72.54%, 76.4% and 11.7% cases. Most common etiology observed was idiopathic (45%) followed by abnormal thrombophilic parameters in 33.3%, umbilical sepsis in 25.49%, umbilical vein catheterization and history of NICU admissions in 19.6% and dehydration due to recurrent diarrhea and vomiting in 11.7%. while amongst the thrombophilic factors studied protein S dedficiency (15.69%) was found to be the most common cause followed by protein C deficiency and antithrombin III deficiency (13.73% each) and factor 5 deificiency in 7.84% cases. Conclusion: The etiology of EHPVO in the majority of patients remain still unclear. It is commonly associated with impaired somatic growth. The risk of EHPVO increases in the presence of thrombophilia, umbilical sepsis, umbilical vein catheterisation and dehydration. The investigations showed abnormal anemia profile and liver function test. [ABSTRACT FROM AUTHOR]