Unique sequelae of portal vein thrombosis in a pediatric patient with cystic echinococcosis: A case report

Abstract

This case report presents a rare complication of hepatic cystic echinococcosis in a 12‐year‐old Latino male, residing in a nonendemic region, who developed long‐term sequelae of portal vein thrombosis accompanied by the emergence of a hyper‐vascular sigmoid colon mass. Portal vein involvement in hepatic cystic echinococcosis is exceedingly uncommon, with limited documented cases. The presentation of the patient included intermittent hematochezia, abdominal pain, and fatigue. Imaging revealed liver cysts and chronic portal vein thrombosis with cavernous transformation, resulting in portal hypertension. Notably, the patient also exhibited mesenteric venous thrombosis, further complicating the clinical picture. The diagnosis was confirmed through echinococcus serology testing. Treatment involved a six month course of Albendazole, puncture‐aspiration‐injection‐reaspiration procedure, splenectomy, and splenorenal shunt to alleviate portal hypertension. This case underscores the significance of considering portal hypertension secondary to hepatic cystic echinococcosis, even in nonendemic regions, particularly in pediatric patients with unique clinical presentations.