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.
KeywordsPortal Vein Portal Hypertension Hepatic Vein Biliary Atresia Portal Vein Thrombosis
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- Nunez D, Russell E, Yrizarry J, Pereiras R, Viamonte M Portosystemic communications studied by transhepatic portography. Radiology 127: 75–79Google Scholar
- Patriquin H, Tessier G, Grignou, A Boisvert J (1985) Lesser omental thickness in normal children: baseline for detection of portal hypertension. AJR 145: 693–696Google Scholar
- 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: 71–76Google Scholar
Portal Vein Thrombosis
- 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: 513–516Google Scholar
Congenital Hepatic Fibrosis
- Grant EG, Perrella RR, Tessler FN et al. (1989) Budd—Chiari syndrome: the results of duplex and color Doppler imaging AIR 152: 377–381Google Scholar
- Lepage JR (1983) Cor triatriatrium dextrum and persistent muscle of lower presenting as Budd—Chiari syndrome. Radiology 134: 491–494Google Scholar
- Menu Y, Alison D, Lorphelin JM, Valla D, Belghiti J, Nahum H Budd Chiari syndrome: US evaluation. Radiology 157: 761–764Google Scholar
- Murphy FB, Steinberg HV, Shires GT, Martin LG, Bernardino ME The Budd—Chiari syndrome: a review. AIR 147: 9–15Google Scholar