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Portal hypertension and its management in children

Tassos Grammatikopoulos1, Patrick James McKiernan2, Anil Dhawan1

  • 1Paediatric Liver, Gastroenterology & Nutrition Centre and MowatLabs, King's College Hospital NHS Foundation Trust, London, UK.

Archives of Disease in Childhood
|August 18, 2017
PubMed

Insights

Pediatric portal hypertension (PHT) management has improved with better diagnosis and risk prediction for gastrointestinal bleeding. New treatments reduce mortality and morbidity in children with PHT.

Area of Science:

  • Pediatric Gastroenterology and Hepatology
  • Vascular Medicine
  • Clinical Management

Background:

  • Portal hypertension (PHT) is elevated pressure in the portal vein system, often stemming from chronic liver disease or vascular issues.
  • PHT complications include gastrointestinal bleeding, a significant concern in pediatric cases.
  • Current management strategies are evolving with advancements in diagnostics and therapeutics.

Purpose of the Study:

  • To review the current state of pediatric portal hypertension (PHT) management.
  • To highlight advancements in diagnosing, monitoring, and predicting gastrointestinal bleeding risk in children with PHT.
  • To discuss the role of consensus in varices classification for future pediatric research.

Main Methods:

  • Review of current invasive (endoscopic, surgical) and non-invasive (pharmacotherapy) techniques for PHT management.
  • Analysis of diagnostic and monitoring advancements.
  • Discussion of risk stratification for gastrointestinal bleeding.

Main Results:

  • Improved diagnostic and monitoring capabilities allow for optimized PHT management in children.
  • Risk prediction for gastrointestinal bleeding aids in surveillance and post-bleeding care.
  • Emerging invasive and non-invasive techniques are contributing to reduced mortality and morbidity.

Conclusions:

  • Optimized management strategies, informed by advanced diagnostics and risk prediction, are crucial for children with PHT.
  • Standardized varices classification is beneficial for future pediatric studies.
  • Current therapeutic advancements offer improved outcomes for pediatric patients suffering from PHT.

Keywords:
BleedingEndoscopyHypersplenismPortal PressureShunt

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