Portal hypertension and its management in children

Arch Dis Child. 2018 Feb;103(2):186-191. doi: 10.1136/archdischild-2015-310022. Epub 2017 Aug 16.

Abstract

Portal hypertension (PHT), defined as raised intravascular pressure in the portal system, is a complication of chronic liver disease or liver vascular occlusion. Advances in our ability to diagnose and monitor the condition but also predict the risk of gastrointestinal bleeding have enabled us to optimise the management of children with PHT either at a surveillance or at a postbleeding stage. A consensus among paediatric centres in the classification of varices can be beneficial in streamlining future paediatric studies. New invasive (endoscopic and surgical procedures) and non-invasive (pharmacotherapy) techniques are currently used enabling clinicians to reduce mortality and morbidity in children with PHT.

Keywords: Bleeding; Endoscopy; Hypersplenism; Portal Pressure; Shunt.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Child
  • Consensus
  • Endoscopy*
  • Gastrointestinal Hemorrhage / prevention & control*
  • Guidelines as Topic
  • Humans
  • Hypertension, Portal / therapy*
  • Portasystemic Shunt, Surgical / methods*
  • Propranolol / therapeutic use*

Substances

  • Adrenergic beta-Antagonists
  • Propranolol