Document Detail


Portal vascular anomalies in Down syndrome: spectrum of clinical presentation and management approach.
MedLine Citation:
PMID:  20713219     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The occurrence of portal vascular anomalies in Down syndrome has been sporadically reported in the literature. These rare disorders have a wide spectrum of anatomical and clinical presentations. The aim of this communication was to describe the clinical course, imaging features, and management approaches in patients with this association.
METHODS: We conducted a comprehensive search of the databases of the Vascular Anomalies Center and the Department of Radiology at Children's Hospital Boston for patients with Down syndrome and portal vascular anomalies. Medical records and imaging studies of varying modalities were reviewed.
RESULTS: Three children with Down syndrome and portal anomalies (portosystemic shunt, simple arterioportal shunt, complex arterioportal shunt) were managed at our institution. The portosystemic shunt was clinically insignificant and resolved without any intervention. The simple arterioportal shunt was successfully treated with embolization. The complex arterioportal shunt was associated with major congenital cardiac defects and the child ultimately expired despite a decrease in the arterioportal shunting after embolization.
CONCLUSIONS: Three is a wide spectrum of clinical and anatomical features of portal vascular shunts in Down syndrome. The management approach should be tailored based on the severity of symptoms. Percutaneous embolization can offer a safe, effective, and minimally invasive alternative to the surgical approach in selective cases.
Authors:
Nazar Golewale; Harriet J Paltiel; Steven J Fishman; Ahmad I Alomari
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  45     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-17     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1676-81     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiology, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Down Syndrome / genetics,  pathology*
Embolization, Therapeutic / methods*
Female
Humans
Infant
Male
Portal System / abnormalities*,  pathology
Portal Vein / abnormalities*,  pathology
Treatment Outcome
Vascular Malformations / diagnosis*,  pathology,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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