Chronic Pancreatitis Presenting with Portal Vein Thrombosis in a Child - A Case Report

Background: Peripancreatic vascular complications have been reported with both acute and chronic pancreatitis (CP), but mainly in adults. Clinical Description: A 3-year-old girl was admitted with complaints of gradual onset abdominal distension and low-grade fever for few months, associated with severe upper abdominal pain. Examination revealed short stature with marked pallor, along with hepatosplenomegaly. Management and Outcome: The child was diagnosed as a CP on the basis of abdominal pain, increased lipase 3 times above the upper range, and calcified lesions in the pancreas in ultrasonography (USG) (INSPIRE Criteria). USG color Doppler confirmed portal vein thrombosis, with decreased blood flow in the portal vein. The child was provided supportive care along with subcutaneous enoxaparin at 1 mg/kg, 12 hourly. At follow-up after 1.5 months, the child was asymptomatic, and USG Doppler showed the absence of thrombus, and enoxaparin was stopped. Conclusion: The case described here creates awareness regarding the rare occurrence of portal vein thrombosis causing extrahepatic portal hypertension in children with CP.