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Digestive Disease Interventions
DOI: 10.1055/s-0044-1782147
Review Article

Pathophysiology, Diagnosis, and Management of Portal Hypertension in the Pediatric Population

Meenal Thadasina Karuvannur 
1   Pediatric Gastroenterology Hepatology Nutrition, Cleveland Clinic Children's Hospital, Cleveland, Ohio
,
Sobia Laique
2   Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
,
Kadakkal Radhakrishnan
1   Pediatric Gastroenterology Hepatology Nutrition, Cleveland Clinic Children's Hospital, Cleveland, Ohio
,
Sameer Gadani
3   Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio
› Author Affiliations
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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


Publication History

Received: 17 January 2024

Accepted: 02 February 2024

Article published online:
06 March 2024

© 2024. Thieme. All rights reserved.

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