Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
190 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Suggest treatment for swollen spleen and splenic vein thrombosis in a 3year old

my little girl is 3 years old and she has had test done over the last 4 months but the doctor will not give any staight answers so I was hoping you could help.She has a swollen spleen. the ultrasound had these findings There is cavernous transformation of the portal vein with 2 primary portal veins in the porta heptis. Marked narrowing of the splenic vein at the juction with the recanalized portal venous collaterals is present surggesting also prior splenic vein thrombosis. There are numerous collateral vesels including portal, esophageal, spleenorenal, mesenteric, gastric and pancreaticoduodenal venous channels. Marked splenomegaly measures approximately 13.6 cm in the longitudinal dimension. The internal architecture enhances homogeneously. The left kidney is compressed.No other abnomality of the kidneys is identified. the liver is not appreciably enlarged and has smooth contours. The pancreas and adrenal are normal. The doctor only would state that we needed to come back in another 9 weeks. Is there anything you can tell me to under stand what is needed for her or what to expect. thanks
Fri, 1 Feb 2019
Report Abuse
Pediatrician 's  Response
Hi,

Sorry to hear that your daughter has some issues related to spleen.

From the history, what I could infer is that she has features of extrahepatic portal venous obstruction. It's not so uncommon in children. Sometimes there can be inciting factors such as umbilical sepsis or catheter insertion during newborn period but most of the time cause is unknown.

Usually these children can develop following issues
1. Bloody vomiting due to increased pressure in the abdominal blood vessels and collateral formation
2. Low hemoglobin (Anemia) or Thrombocytopenia (low platelets) due to enlarged spleen
3. Splenic injury during contact sport or fall.

If it is extra hepatic portal venous obstruction, your child needs regular Endoscopy and follow up with pediatric gastroenterologist. If any massive bleed is there, it needs to be addressed immediately.

on the long term, surgery like shunts (splenic renal) can be done to reduce the pressure in the abdominal blood vessels.

Rarely splenectomy is indicated. Management based on the symptoms and it varies with individuals. I would suggest you to follow up with a pediatric gastroenterologist for further care.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Nirubhan Bharathy, Pediatrician
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]
Share on
 

Related questions you may be interested in

doctor1 MD

i was diagnosed with deep vein thrombosis and was recently told it was not going away and had to live with my swollen right lrg for the rest of my...

Recent questions on  Hepatic portal vein

doctor1 MD

my little girl is 3 years old and she has had test done over the last 4 months but the doctor will not give any staight answers so I was hoping you...

doctor1 MD

My father suffers from convulsions and high fever. the fever comes swiftly followed by fainting, excess perspiration, convulsions, low BP. it lasts...

doctor1 MD

Hello Dr. My brother suffers from gastric varicose since he was 8 years old as a result of transferring him some blood via his bundle when he was 2...

doctor1 MD

My husband has portal vein thrombosis with portal hypertension. Due to an increase in his propranolol to 80mg he has not had a bleeding episode in...

doctor1 MD

I had an abdominal ultra sound a while back, and it was discovered that I have an enlarged hepa portal vein. I was questioned as to whether I had...

doctor1 MD

Dr. Narasi...here is my question. Though I'm aware the spleen is composed of blood vessels, and there is a splenic artery that runs from spleen to...

doctor1 MD

Approximately three years ago I had a EGD. I was diagnosed with gastric varices ( varicose veins ) of the stomach wall. I do not drink or smoke. I...