Umbilical Vein Catheterization and Portal Hypertension

Abstract

Portal hypertension is a rarely encountered late complication of umbilical vein catheterization. A survey of the 38 cases previously published is presented together with an additional case report. It is concluded that catheterization for more than 2 days carries an increased risk of thrombosis, and that umbilical artery catheterization should be preferred in the majority of cases due to a reduced risk of complications. The correct position of the catheter tip must always be controlled by fluoroscopy or X-ray. Infusion of hypertonic solutions with unphysiological pH should be restricted and umbilical vessel catheterization should only be carried out in severe cases. Pretreatment of the catheters with heparin possibly reduces the hazards.

Portal vein thrombosis in the neonate: Risk factors, course, and outcome

“…This study and other case reports demonstrate the importance of long-term follow-up of infants with PVT. 2,19 Atrophy of the left hepatic lobe, previously considered a normal variant, 20,21 was diagnosed in 30 infants. A correlation between hepatic lobar atrophy and ipsilateral portal vein obstruction has been reported in adults.…”

Variceal bleeding due to idiopathic portal vein thrombosis in a 15‐year‐old boy

“…Portal vein thrombosis (PVT) as a manifestation of VTE may occur in children with underlying risk factors such as malignancy, inherited thrombophilia, infections, splenectomy, sickle cell disease, chemotherapy, or the presence of antiphospholipid antibodies. Furthermore, it can present as a complication following pediatric liver transplantation …”

“…Furthermore, it can present as a complication following pediatric liver transplantation. [2][3][4][5][6][7][8][9] We report a case of an idiopathic portal vein thrombosis in a child, presenting with portal hypertension, esophageal and rectal varices, splenomegaly, and gastrointestinal bleeding with unconfirmed etiology in known medical conditions.…”

The evaluation and management of postnatal thromboses

“…Attempts to minimize complications associated with UVCs focus on prompt removal after a short period of use. 67 The Centers for Disease Control and Prevention currently recommend use of UVCs be limited to 14 days. 68 A randomized trial compared long-term UVC use (up to 28 days) with short-term (7 to 10 days) use followed by peripheral CVL placement; investigators found that in the short-term group, 9% developed thrombi with 4% being clinically significant compared with 13 and 7%, respectively, in the long-term group.…”