[Portal hypertension in children: 75 cases]

This article reports a retrospective study on 75 children who had portal hypertension (PHT) who were hospitalized at the childrens hospital of Casablanca in Morocco over a period of 12 years. The goal of this study is to consider the epidemiologic clinical and etiologic aspects of this ailment and to emphasize the prevention of digestive hemorrhages. The results obtained show a mean of 4 cases of PHT per year seen in a general pediatric department. The mean age of patients is 5 years and 6 months predominantly of male sex (56%). Clinical examination finds splenomegaly in 92% of cases; it is associated with a collateral artery in 68% of observed cases ascites is found in 53% of patients as well as digestive hemorrhage in 56% of cases and hepatomegaly in 26.6% of cases. Fiberoptic endoscopy identified esophageal varices in 52 cases and sonographic signs of PHT were detected through abdominal ultrasound. The etiologies of portal hypertension observed in 2/3rds of cases are dominated by posthepatic cirrhosis in 37 patients and portal cavernoma in 15 cases. They represent the primary cause of PHT in children in the Moroccan context. Sclerosis of esophageal varices by endoscopic means remains the method of choice in the prevention of digestive hemorrhages it allows control of bleeding in an emergency situation. In conclusion the authors emphasize the difficulties of managing digestive hemorrhages caused by ruptures of esophageal varices.