Abstract
Portal hypertension is defined as elevation of the corrected portal pressure above 10 cm H2O (portal pressure minus IVC pressure) or of the absolute portal pressure above 20 cm H2O. On a practical point of view the portal pressure can be measured by direct transhepatic portography or by splenoportography. The clinical consequence is splenomegaly, the spleen acting as a reservoir for splanchnic venous blood. Development of collaterals between the portal venous system and the caval systemic venous system is common. Some of these collaterals are submucosal in the digestive tract: oesophagus, duodenum and rectum. These collaterals and only these can carry the risk of bleeding. The other collaterals shunt the portal system to the vena cava and rarely lead to portal encephalopathy in children. These collaterals per se are extremely rarely sufficient to allow a normalisation of the portal pressure.
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Bibliography
General
Balkanei F, Farid N, Guran S, Senaati S, Atique MH, Yuce A (1991) A high incidence of spontaneous splenorenal shunting shown by digital splenoportography. Pediatr Radiol 21: 145–147
Bernard O, Alavarez F, Brunelle F, Hadchouel P, Alagille D (1985) Portal hypertension in children. Clin Gastroenterol 14: 33–35
Boucher D, Brunelle F, Bernard O et al. (1985) Ultrasonic demonstration of portocaval anastomosis in portal hypertension in children, Pediatr Radiol 15: 307–310
Brunelle F, Alagille D, Pariente D, Chaumont P (1981) An ultrasound study of portal hypertension in children. Ann Radiol 24: 121–130
Nunez D, Russell E, Yrizarry J, Pereiras R, Viamonte M Portosystemic communications studied by transhepatic portography. Radiology 127: 75–79
Patriquin H, Tessier G, Grignou, A Boisvert J (1985) Lesser omental thickness in normal children: baseline for detection of portal hypertension. AJR 145: 693–696
Patriquin H, Lafortune M, Burns P et al. (1987) The duplex Doppler examination of children and adults with portal hypertension. Technique and anatomy AIR 149: 71–76
Patriquin H, Lafortune M, Weber A et al. (1987) Surgical portosystemic shunts in children: assessment with duplex Doppler US. Radiology 165: 25–28
Portal Vein Thrombosis
Alvarez F, Bernard O, Brunelle F et al. (1983) Portal obstruction in children 1-Clinical investigation and hemorrhage risk. J Pediatr 103: 696–702
Alvarez F, Bernard O, Brunelle F et al. (1983) Portal obstruction in children 2-Results of portosystemic shunt. J Pediatr 103: 703–707
Choudhuri G, Tandon RK, Nundy S, Misra NK (1988) Common bile duct obstruction by portal cavernoma. Dig Dis Sci 33: 1626–1628
Dilawari JB, Chawla YK (1992) Pseudosclerosing cholangitis in extrahepatic portal venous obstruction. Gut 33: 272–276
Slovis TL, Haller JO, Cohen HL, Berdon WE, Watts FB (1989) Complicated appendiceal inflammatory disease in children: pylephlebitis and liver abscess. Radiology 171: 823–825
Cirrhosis
Abramson SJ, Berdon WE, Altman RP et al. (1987) Biliary atresia and non-cardiac polysplenic syndrome: US and surgical considerations. Radiology 163: 377–380
Falchetti D, Brant de Carvalho F, Clapuyt P et al. (1991) Liver transplantation in children with biliary atresia and polysplenia syndrome. J Pediatr Surg 26: 528–531
Gibson RN, Gibson PR, Doulan JD, Clunie DA (1989) Identification of a patent paraumbilical vein by using Doppler sonography: importance in the diagnosis of portal hypertension. AIR 153: 513–516
Karrer FM, Hall RI, Lilly JR (1991) Biliary atresia and the polysplenia syndrome. J Pediatr Surg 26: 524–527
Congenital Hepatic Fibrosis
Alvarez F, Bernard O, Brunelle F et al. (1981) Congenital hepatic fibrosis in children. J Pediatr 99: 370–375
Odièvre M, Chaumont P, Montagne JP, Alagille D (1977) Anomalies of the intrahepatic portal venous system in congenital hepatic fibrosis. Radiology 122: 427–430
Budd—Chiari Syndrome
Brunelle F, Leblanc A, Chaumont P (1981) Familial Budd-Chiari disease: angiographie study in two sisters. Pediatr Radiol 11: 91–95
Gentil-Kocher S, Bernard O, Brunelle F (1988) Budd—Chiari syndrome in children: report of 22 cases. J Pediatr 113: 30–38
Grant EG, Perrella RR, Tessler FN et al. (1989) Budd—Chiari syndrome: the results of duplex and color Doppler imaging AIR 152: 377–381
Lepage JR (1983) Cor triatriatrium dextrum and persistent muscle of lower presenting as Budd—Chiari syndrome. Radiology 134: 491–494
Lois JF, Hartzmann S, Mc Glade CT, Gomes AS (1989) Budd Chiari syndrome: treatment with percutaneous trans-hepatic recanalization and dilatation. Radiology 170: 791–793
Menu Y, Alison D, Lorphelin JM, Valla D, Belghiti J, Nahum H Budd Chiari syndrome: US evaluation. Radiology 157: 761–764
Murphy FB, Steinberg HV, Shires GT, Martin LG, Bernardino ME The Budd—Chiari syndrome: a review. AIR 147: 9–15
Pariente D, Gentil-Kocher S, Brunelle F, Bernard O, Chaumont P (1987) Budd—Chiari syndrome in children: radiologie investigation. Ann Radiol 30: 518–524
Radice L, Roche A, Gallaire C, Martin Lalardrie B, Kraiem C (1985) Maladie de Budd—Chiari de l’adulte: diagnostic, bilan et approche fonctionelle par]’artériographie hépatique. Ann Radiol 28: 513–518
Stanley P (1989) Budd—Chiari syndrome. Radiology 170: 625–627
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© 1994 Springer-Verlag London
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Brunelle, F., Pariente, D., Chaumont, P. (1994). Portal Hypertension. In: Liver Disease in Children. Springer, London. https://doi.org/10.1007/978-1-4471-3822-8_3
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DOI: https://doi.org/10.1007/978-1-4471-3822-8_3
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