Background: Neonatal portal vein thrombosis (PVT) is currently more commonly encountered as a result of advances in diagnostic tools and increase in invasive interventions.
Methods: In this study, 11 premature and 12 term infants diagnosed with PVT were retrospectively evaluated for clinical and laboratory characteristics, umbilical catheterization procedure, PVT location, risk factors, treatments, and long-term outcomes.
Results: Median age of the patients at diagnosis was 10 days (range 3-90 days), and 69.6% of patients were girls. Of the 23 patients, 87% had left PVT and, 91.3% had at least one thrombosis risk factor, which was sepsis in 73.9% of patients, and presence of umbilical venous catheter in 87%. Totally, 59.1% of PVTs were completely resolved in a median follow-up of 7 months (1 month to 12 months), and 78.3% of these patients had no anticoagulant therapy (ACT). Partial thrombus resolution was achieved in 9 patients (40.9%). Five patients (%21) received ACT. Overall, 34.8% of patients had long-term complications. neonatal PVT is most commonly reported in the left portal vein and there is no evidence for the impact of ACT on reducing the short- or long-term complications. Well designed and larger studies are necessary to clarify this issue, which can facilitate developing appropriate management algorithms.
Conclusion: Neonatal PVT is most commonly reported in the left portal vein and there is no evidence for the impact of ACT on reducing the short- or long-term complications. Well designed and larger studies are necessary to clarify this issue, which can facilitate developing appropriate management algorithms.
The overall incidence rate of PVT was 0,79/1000 neonatal intensive care admissions, possibly an underestimation of the incidence of true PVT. UVC insertion and sepsis were the leading potential risk factors for PVT.Among 23 infants, both of neonates showed partial or complete PVT resolution with 9(%39) and 14(%61) respectively, within 18,4 days (4 days to 4 months). In both premature and term neonates the PR and CR rates were similiar.(40% and 60% versus 37% and %63).In ACT recipients group (ACT group) and ACT non- recipients group(No ACT group), PR or CR mean duration were 38,6 days (8 days to 4 months) and 12,6 days (4 days to 3 months) respectively. This information may show us that the benefit of ACT therapy in the resolution of PVT is doubtful, and that wait-and-watch management should be prioritized in the profit-loss relationship.11 articles were included in the systematic review of literature. Total 183 neonates 102 were ACT untreated and 81 were ACT treated. Overall PR and CR are displayed on Table 4.Long-term complication rate was 8/23(%34) with mean 7 months(1 to 12 months) follow-up duration.
Keywords: Clinical features; Demographic features; Neonatal; Outcomes; Portal vein thrombosis; Risk factors.
© 2023. The Author(s).