Derivación no convencional en la obstrucción venosa portal extrahepática en paciente pediátrico: reporte de caso

Abstract

Extrahepatic portal venous obstruction in pediatric patients is associated with extrahepatic portal vein thrombosis, considered the most common cause for developing this pathology. It can be compensated by creating spontaneous portosystemic shunt, but some patients experience gastrointestinal bleeding that requires surgical interventions due to its severity and poor prognosis. The condition is frequently associated with portal cavernomatosis and collateral vessel formation, eventually triggering portal hypertension. Several surgical techniques have been developed, such as mesocaval shunt, coronary-caval shunt, inferior mesenteric vein-left renal vein, proximal splenorenal, distal splenorenal, and mesenteric-intrahepatic left portal vein shunts, which are adapted to the patient's anatomy and clinical conditions. OBJECTIVE: To describe the pediatric case of an unconventional shunt in extrahepatic portal venous obstruction. METHODOLOGY: In the present work, a descriptive study will be carried out on the clinical case based on a clinical history reported at the Vicente Corral Moscoso Hospital in Cuenca-Ecuador. The theoretical framework and discussion information will be taken from scientific databases such as PubMed, ScienceDirect, Elsevier, Cochrane, and Scopus in English and Spanish. RESULTS: Describing surgical options in a pediatric patient with prehepatic portal hypertension, which is complex and of interest due to congenital or acquired vascular variations. In addition, it aims to provide a publication that has not been previously generated in our environment and has few reports worldwide.