Final Pr. ID: Poster #: CR-025
Pulmonary vein thrombosis is an exceedingly rare occurrence but should be considered in the differentials in evaluation for opacity seen on the chest radiograph, in a coagulopathic pediatric patient. Read More
Final Pr. ID: Poster #: EDU-029
To present a series of patients with pylephlebitis without a significant past medical history Read More
Final Pr. ID: Poster #: EDU-004
Venous thromboembolism (VTE) is a multifactorial disease and a significant source of morbidity. Though the incidence of VTE, composed of deep venous thrombosis (DVT) and pulmonary emobolism (PE), is more common in adults, an increasing number of children are being diagnosed. Children who are critically ill are at greatest risk of developing VTE.
Duplex sonography is a critical front line tool in the detection and evaluation of venous thrombosis. Serial surveillance examinations allow real-time assessment of thrombosis including propagation and progression.
Recognizing the presentation and sonographic appearance of venous thrombosis assists the clinician in timely therapeutic decision-making and clinical management.
The goals of this exhibit are:
1. Describe the technical approach of performing duplex vascular ultrasound, including tips and technology that assist in optimizing studies.
2. Discuss the incidence, risk factors, and clinical characteristics of pediatric VTE.
3. Depict the sonographic appearance of thrombosis with emphasis on correlation to other modalities.
4. Discuss prognosis and long-term outcomes of VTE in children.
5. Describe future techniques and applications. Read More
Final Pr. ID: Paper #: 120
Neonates with prolonged hospitalization often require PICCs. The concern for PICC-related complications, including venous thrombosis, infection, catheter migration and breakage, often prompts Doppler ultrasound (US) evaluation. However, peri-catheter thrombus in a neonate can be challenging to evaluate, as the accessed peripheral veins in neonates are small, some less than 1mm in luminal diameter. Small-bore catheters may occupy the entirety of the vessel lumen, which can produce absence of peri-catheter flow, which is confounding for thrombus. This distinction has implications for hematologic management. Read More
Final Pr. ID: Poster #: CR-066
We present a radiologic case of a teenager with portal, inferior mesenteric, superior mesenteric, and splenic vein thromboses presenting with acute abdominal pain and treated conservatively with anticoagulation therapy. Ultrasound and computed tomography were done at the acute presentation and follow up magnetic resonance images were performed. One year of anticoagulation therapy correlated with almost complete resolution of splanchnic thrombosis; however, the superior mesenteric vein continues to remain severely dilated close to the confluence on subsequent annual imaging. The initial imaging also diagnosed multiple phlebolith in the pelvis. We suspect this is a congenital malformation of the porto-splanchnic circulation presenting with acute thrombosis. Differential is variceal dilatation as sequela of extensive thrombosis. Read More
Final Pr. ID: Paper #: 075
Portal vein thrombosis (PVT) is a major cause of pediatric portal hypertension and gastrointestinal (GI) bleeding. Recanalization with balloon angioplasty (BA) and stent placement have emerged as a minimally invasive treatment option for PVT. We sought to review the success and complication rates of transcatheter PVT therapy in pediatric patients with native liver. Read More
Final Pr. ID: Poster #: CR-006
Midgut volvulus in children is uncommon, but diagnosis of portal vein thrombosis in association with midgut volvulus has been rarely reported. We present a case of a 3-year old male with an unusual presentation of recurrent episodic abdominal pain suspected initially having ileocolic intussusception. Cross-sectional imaging identified extensive acute portomesenteric thrombosis in the setting of suspected midgut volvulus, which was confirmed on upper GI series and at surgery. A thrombophilia workup was negative. To our knowledge, this is the first case of acute portal vein and superior mesenteric vein thrombosis with splenic vein extension in association with midgut volvulus. When the diagnosis remains elusive and imaging demonstrates an extensive acute PVT with SMV extension in children and adolescents, radiologists should consider midgut volvulus in addition to other etiologies, such as malignancy, cirrhosis, or bowel inflammation. Read More