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Updated: Aug 28, 2025
Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Pediatric liver cirrhosis interventional procedures: from biopsy to transjugular intrahepatic portosystemic shunt
Gian Luigi Natali1, Giulia Cassanelli2, Guglielmo Paolantonio3
1Interventional Radiology Unit in Oncohematology, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio, 4, 00165, Rome, Italy. gianluigi.natali@opbg.net.
Insights
Interventional radiology offers diagnostic and therapeutic solutions for pediatric liver cirrhosis and portal hypertension. Procedures like image-guided biopsy and various shunts help manage these complex conditions in children.
Area of Science:
- Pediatric Gastroenterology
- Interventional Radiology
- Hepatology
Background:
- Cirrhosis involves liver architectural distortion due to fibrosis, leading to abnormal nodules.
- Pediatric conditions like biliary atresia and autoimmune hepatitis can cause cirrhosis and portal hypertension.
- Portal hypertension is a significant complication in pediatric liver disease.
Purpose of the Study:
- To describe interventional radiology procedures for diagnosing and treating pediatric liver cirrhosis and portal hypertension.
- To highlight the role of minimally invasive techniques in managing pediatric liver disease complications.
Main Methods:
- Image-guided liver biopsy for diagnosis.
- Mesenteric-intrahepatic left portal vein shunts.
- Balloon-occluded retrograde transvenous obliteration.
- Transjugular intrahepatic portosystemic shunts.
- Splenic embolization.
Main Results:
- Interventional radiology procedures provide effective diagnostic capabilities.
- These procedures offer therapeutic options for managing complications of pediatric cirrhosis and portal hypertension.
- Minimally invasive techniques can improve patient outcomes.
Conclusions:
- Interventional radiology plays a crucial role in the multidisciplinary management of pediatric liver cirrhosis.
- The described procedures offer valuable tools for addressing the challenges of portal hypertension in children.
- Further research can optimize these techniques for pediatric applications.
Abstract:
Cirrhosis is a complex diffuse process whereby the architecture of the liver is replaced by abnormal nodules because of the presence of fibrosis. Several pediatric diseases such as extrahepatic portal vein obstruction, biliary atresia, alpha-1-antitrypsin deficit and autoimmune hepatitis can lead to cirrhosis and portal hypertension in children. In this article the authors describe interventional radiology procedures that can facilitate the diagnosis and treatment of diseases associated with liver cirrhosis and portal hypertension in the pediatric population. These procedures include image-guided liver biopsy, mesenteric-intrahepatic left portal vein shunts, balloon-occluded retrograde transvenous obliteration, transjugular intrahepatic portosystemic shunts and splenic embolization.
