GALLBLADDER VARICES - DIAGNOSIS IN CHILDREN WITH PORTAL-HYPERTENSION ON DUPLEX SONOGRAPHY

We established the prevalence of gallbladder varices (GBVs) as seen on duplex sonogram of children with portal hypertension. Fifty-five cons ecutive children with portal hypertension underwent duplex sonographic examination by an experienced sonologist who was blinded to clinical presentation. Forty children had extrahepatic portovenous obstruction (EHPVO), 12 had cirrhosis, and three had noncirrhotic portal hypertens ion. GBVs were seen on sonography in 10 of 40 children with EHPVO (25% ), two of 12 children with cirrhosis (16.6%), and no children with non cirrhotic portal hypertension. Sonographic findings of GBVs were confi rmed on duplex sonographic imagine. Among patients with EHPVO, GBVs di d not correlate with size of esophageal varices, number of sessions of sclerotherapy, presence or absence of gastric varices, portal gastrop athy, or splenorenal shunt placement. In cirrhotic patients, GBVs did not correlate with Child Pugh grade. Children with EHPVO have a higher incidence of developing GBVs. The clinical significance of GBVs is th eir propensity to bleed during biliary surgery; thus, the operating su rgeon should be made aware of them.