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Advances in the management of childhood portal hypertension.
Expert Rev Gastroenterol Hepatol. 2015 May; 9(5):575-83.ER

Abstract

Portal hypertension is one of the most serious complications of childhood liver disease, and variceal bleeding is the most feared complication. Most portal hypertension results from cirrhosis but extra hepatic portal vein obstruction is the single commonest cause. Upper gastrointestinal endoscopy endoscopy remains necessary to diagnose gastro-esophageal varices. Families of children with portal hypertension should be provided with written instructions in case of gastrointestinal bleeding. Children with large varices should be considered for primary prophylaxis on a case-by-case basis. The preferred method is variceal band ligation. Children with acute bleeding should be admitted to hospital and treated with antibiotics and pharmacotherapy before urgent therapeutic endoscopy. All children who have bled should then receive secondary prophylaxis. The preferred method is variceal band ligation and as yet there is little evidence to support the use of β-blockers. Children with extrahepatic portal vein obstruction should be assessed for suitability of mesoportal bypass.

Authors+Show Affiliations

Liver Unit, Birmingham Children's Hospital, Birmingham B4 6NH, UK.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25539572

Citation

McKiernan, Patrick, and Mona Abdel-Hady. "Advances in the Management of Childhood Portal Hypertension." Expert Review of Gastroenterology & Hepatology, vol. 9, no. 5, 2015, pp. 575-83.
McKiernan P, Abdel-Hady M. Advances in the management of childhood portal hypertension. Expert Rev Gastroenterol Hepatol. 2015;9(5):575-83.
McKiernan, P., & Abdel-Hady, M. (2015). Advances in the management of childhood portal hypertension. Expert Review of Gastroenterology & Hepatology, 9(5), 575-83. https://doi.org/10.1586/17474124.2015.993610
McKiernan P, Abdel-Hady M. Advances in the Management of Childhood Portal Hypertension. Expert Rev Gastroenterol Hepatol. 2015;9(5):575-83. PubMed PMID: 25539572.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advances in the management of childhood portal hypertension. AU - McKiernan,Patrick, AU - Abdel-Hady,Mona, Y1 - 2014/12/25/ PY - 2014/12/26/entrez PY - 2014/12/30/pubmed PY - 2016/1/12/medline KW - TIPS KW - children KW - endoscopic variceal ligation KW - esophageal varices KW - hematemesis KW - meso-portal KW - portal hypertension KW - portosystemic shunts KW - β blockers SP - 575 EP - 83 JF - Expert review of gastroenterology & hepatology JO - Expert Rev Gastroenterol Hepatol VL - 9 IS - 5 N2 - Portal hypertension is one of the most serious complications of childhood liver disease, and variceal bleeding is the most feared complication. Most portal hypertension results from cirrhosis but extra hepatic portal vein obstruction is the single commonest cause. Upper gastrointestinal endoscopy endoscopy remains necessary to diagnose gastro-esophageal varices. Families of children with portal hypertension should be provided with written instructions in case of gastrointestinal bleeding. Children with large varices should be considered for primary prophylaxis on a case-by-case basis. The preferred method is variceal band ligation. Children with acute bleeding should be admitted to hospital and treated with antibiotics and pharmacotherapy before urgent therapeutic endoscopy. All children who have bled should then receive secondary prophylaxis. The preferred method is variceal band ligation and as yet there is little evidence to support the use of β-blockers. Children with extrahepatic portal vein obstruction should be assessed for suitability of mesoportal bypass. SN - 1747-4132 UR - https://www.unboundmedicine.com/medline/citation/25539572/Advances_in_the_management_of_childhood_portal_hypertension_ L2 - https://www.tandfonline.com/doi/full/10.1586/17474124.2015.993610 DB - PRIME DP - Unbound Medicine ER -