Etiology and Management of Hemorrhagic Complications of Portal Hypertension in Children

Table 1

Common causes of portal hypertension in children and suggested management.

Cause	Treatment	Comment
	(1) Endoscopic
Portal vein obstruction	(2) Meso-Rex shunt	Endoscopic treatment consists on elastic banding or sclerotherapy
	(3) DSR or mesocaval shunt
Biliary atresia	(1) Endoscopic	Screening at age of 1, prophylaxis in high-risk varices
	(2) Liver transplantation
	(1) Endoscopic	Need repetitive anesthetics
Cystic fibrosis	(2) DSR or meso-caval shunt	Risk of pulmonary complications and worsening encephalopathy
	(3) Liver transplantation	When good respiratory function
	(1) Endoscopic
Congenital hepatic fibrosis	(2) DSR or meso-caval shunt	When recurrent cholangitis (need to consider liver and kidney tranplantation)
	(3) Liver transplantation
	(1) Endoscopic
Other cirrhosis	(2) DSR or meso-caval shunt	If good liver function
	(3) Liver transplantation	In end-stage liver disease

DSR: distal spleno-renal shunt.