1.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
2.Transitioning Pediatric Patients with Inflammatory Bowel Disease:Key Considerations for Adult Gastroenterologists
Ahmed ALWASSIEF ; Qasim L ABBAS ; Said AL BUSAFI ; Tawfiq T AL LAWATI ; Khalid AL SHMUSI
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(3):141-147
The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.
3.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
4.Transitioning Pediatric Patients with Inflammatory Bowel Disease:Key Considerations for Adult Gastroenterologists
Ahmed ALWASSIEF ; Qasim L ABBAS ; Said AL BUSAFI ; Tawfiq T AL LAWATI ; Khalid AL SHMUSI
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(3):141-147
The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.
5.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
6.Transitioning Pediatric Patients with Inflammatory Bowel Disease:Key Considerations for Adult Gastroenterologists
Ahmed ALWASSIEF ; Qasim L ABBAS ; Said AL BUSAFI ; Tawfiq T AL LAWATI ; Khalid AL SHMUSI
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(3):141-147
The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.
7.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
8.Transitioning Pediatric Patients with Inflammatory Bowel Disease:Key Considerations for Adult Gastroenterologists
Ahmed ALWASSIEF ; Qasim L ABBAS ; Said AL BUSAFI ; Tawfiq T AL LAWATI ; Khalid AL SHMUSI
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(3):141-147
The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.
9.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
10.Transitioning Pediatric Patients with Inflammatory Bowel Disease:Key Considerations for Adult Gastroenterologists
Ahmed ALWASSIEF ; Qasim L ABBAS ; Said AL BUSAFI ; Tawfiq T AL LAWATI ; Khalid AL SHMUSI
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(3):141-147
The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.

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