ABSTRACT

The treatment of portal hypertension in both children and adults remains the subject of considerable controversy. Therapeutic options now include a broad range of pharmacologic, endoscopic, interventional, and surgical procedures. The etiology of portal hypertension is different

from that in adults, however. In adults, the vast majority of cases are caused by cirrhosis (usually due to alcohol abuse or viral infection), whereas in children portal hypertension is due to portal vein thrombosis (PVT) in up to 50 percent of cases. When cirrhosis is the cause in children, it is usually secondary to biliary atresia (BA). The differing etiologies of portal hypertension compel a distinct management approach.