Etiological spectrum and clinical profile of Portal Hypertension in Children at A Tertiary Care Hospital

Background: Definition of Portal hypertension is a clinical syndrome characterized by a pathologic increase of portal venous pressure.This study aims to investigate the clinical, laboratory, and etiological profiles of portal hypertension in children at a tertiary care hospital in Bangladesh.Methods: A descriptive type of cross-sectional study was conducted at the Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Bangladesh Shishu Hospital and Institute, from January 2022 to December 2024.A total of 64 children aged 0-18 years diagnosed with portal hypertension, either clinically or radiologically, were enrolled using purposive sampling.Data were analyzed using descriptive statistics by SPSS version 25.0.Result: Among the 64 children studied, 65.6% were male, with the majority aged 6-10 years.The most common cause was Portal vein thrombosis (54.7%).Patients with Cirrhotic liver were more frequently exhibited hepatomegaly, jaundice, ascites, coagulopathy, and elevated liver enzymes, while non-cirrhotic patients had higher rates of anemia and thrombocytopenia due to hypersplenism.Esophageal varices and variceal bleeding were common in both groups, but advanced complications like hepatic encephalopathy and hepatorenal syndrome were seen only in the cirrhotic group.Conclusion: Extrahepatic portal vein obstruction, cryptogenic cause, Wilson disease, and biliary atresia were the most prevalent causes of portal hypertension in this study.The most common cause of extra-hepatic portal venous obstruction was Portal vein thrombosis.Gastrointestinal bleeding and splenomegaly were found in most of the cases of non-cirrhotic portal hypertension.Hepatomegaly, increased transaminase levels, and synthesis dysfunction were suggestive of cirrhotic Portal hypertension.