Abstract
Portal hypertension is caused by resistance to the portal blood flow, which most commonly
occurs in the setting of cirrhosis. Complications of portal hypertension can cause
significant morbidity and mortality in the pediatric population. Portal hypertension
is diagnosed when the hepatic venous pressure gradient (HVPG) is more than 5 mm Hg,
and potential bleeding complications from esophageal and gastric varices are more
likely when the HVPG is more than 10 mm Hg. Diagnosis can be made clinically; however, liver biopsy with measurement of the HVPG
is ultimately required. The management of portal hypertension in pediatric patients
is typically aimed at treatment of the complications. Despite the multiple pharmacologic,
endoscopic, surgical, and interventional radiologic management techniques that are
available, some pediatric patients will ultimately require liver transplant. Prompt
referral is needed in such cases.
Keywords
portal hypertension - hepatic venous pressure gradient - cirrhosis - transjugular
portosystemic shunt
