PORTAL-HYPERTENSION IN CHILDREN AND YOUNG-ADULTS - SONOGRAPHIC AND COLOR DOPPLER FINDINGS

Portal hypertension is a relatively uncommon pathologic condition in c hildren and young adults in contrast with older adults. The aim of thi s study is to evaluate the utility of sonography and color Doppler son ography in the diagnosis of portal hypertension in children and young patients and to evaluate the sonographic pattern of each disease. We r eviewed 25 such patients who were younger than 30 years old and obtain ed the following sonographic findings: (1) liver cirrhosis: (a) multip le intrahepatic venovenous shunts in patients with primary Budd-Chiari syndrome and (b) intrahepatic vascular narrowing and nodular coarse p arenchymal texture, with multiple very-high-echo spots along the porta l vein in patients with Wilson disease; (2) congenital hepatic fibrosi s: marked and developed collaterals, wide periportal echogenic band, a nd a heterogeneous parenchymal texture comprised of multiple high echo es but without portal thrombus; and (3) extrahepatic portal thrombosis : invisible portal lumen except as an echogenic band, Sonography and c olor Doppler sonography are very useful in diagnosing these portal hyp ertensive diseases. However, there are no specific sonographic finding s, and the role of sonography is limited to followup observation of as sociated secondary hepatobiliary changes in patients with congenital b iliary atresia.