{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:33:45Z","timestamp":1787740425599,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2008,11,1]],"date-time":"2008-11-01T00:00:00Z","timestamp":1225497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective:<\/jats:title><jats:p>To study a single\u2010centre experience of the management of extrahepatic portal vein obstruction (EHPVO) in children during the last 3 decades.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods:<\/jats:title><jats:p>The medical records of 108 children (67 male, median age 4.75 years, range = 1 day\u201316.3 years) presenting with EHPVO between 1979 and 2005 were reviewed retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Extended prothrombotic screening performed in 30 patients revealed low protein C activity (6 patients), low free protein S (2), and a positive lupus anticoagulant (1); factor V Leiden mutations and the JAK2V617F mutation were not identified. Associated congenital anomalies were found in 26 of the 108 children (24%). Clinical presentation included splenomegaly in 98 (91%) and ascites in 3 (3%). Elevation of liver enzymes and prolonged international normalized ratio were seen in 13 (12%) and 14 (13%) children, respectively. Haematological parameters of hypersplenism were present in 13 (12%). Bleeding occurred in 83 (77%) patients with a median age of 4.58 (0.02\u201316.37) years. On first endoscopy, oesophageal varices were present in 92 patients; of those subjects, 70 (76%) received sclerotherapy, 5 (5%) had band ligation, and 16 (17%) received both. Complications of endoscopy occurred in 34 (37%) patients: oesophageal ulcers in 16, oesophageal stricture in 10, both in 7, and erosive gastritis in 1. Seventeen (16%) children underwent shunt surgery for uncontrolled bleeding at a median age of 9.7 (5.2\u201323.7) years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The aetiology of EHPVO in the majority of patients remains unknown. Sclerotherapy and banding are effective treatments for bleeding varices with good long\u2010term outcome. Procoagulant state is an infrequent cause of EHPVO in children.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e31817b6eea","type":"journal-article","created":{"date-parts":[[2010,2,25]],"date-time":"2010-02-25T06:42:44Z","timestamp":1267080164000},"page":"630-634","source":"Crossref","is-referenced-by-count":78,"title":["Aetiology and Management of Extrahepatic Portal Vein Obstruction in Children: King's College Hospital Experience"],"prefix":"10.1002","volume":"47","author":[{"given":"Nehal","family":"Abd El\u2010hamid","sequence":"first","affiliation":[{"name":"Paediatric Liver Centre King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M","family":"Taylor","sequence":"additional","affiliation":[{"name":"Paediatric Liver Centre King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Marinello","sequence":"additional","affiliation":[{"name":"Paediatric Liver Centre King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GJ","family":"Mufti","sequence":"additional","affiliation":[{"name":"Paediatric Liver Centre King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Patel","sequence":"additional","affiliation":[{"name":"Paediatric Liver Centre King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgina","family":"Mieli\u2010Vergani","sequence":"additional","affiliation":[{"name":"Paediatric Liver Centre King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Davenport","sequence":"additional","affiliation":[{"name":"Paediatric Liver Centre King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Dhawan","sequence":"additional","affiliation":[{"name":"Paediatric Liver Centre King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,11]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2005.06.004"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-28032003000400009"},{"key":"e_1_2_5_4_1","first-page":"236","article-title":"Leiden and prothrombin gene G20210A mutations are uncommon in portal vein thrombosis in India","volume":"25","author":"Sharma S","year":"2006","journal-title":"Indian J Gastroenterol"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051113"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.04.008"},{"key":"e_1_2_5_7_1","first-page":"442","article-title":"Ammonia tolerance in the diagnosis of esophageal varices. 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