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.
KeywordsCatheter Hepatitis Aspirin Dehydration Meningitis
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