ABSTRACT
Splenomegaly can be detected in infancy or early childhood and can easily be misinterpreted as a sign of a haematological condition - particularly in children with no other signs of liver disease. In addition to splenic enlargement, patients may present with severe thrombocytopenia and leucopenia from splenic sequestration of platelets and white blood cells. Complications of portal hypertension include all of the items listed and they may be the presenting symptom that brings the patient to medical attention. Clinically evident encephalopathy may be a sign of advanced liver disease and can be exacerbated by gastrointestinal bleeding. A liver biopsy may prove very useful in a child with jaundice to determine the nature of the liver disease if blood work and ultrasound are not conclusive. Not all gastrointestinal bleeding in children is caused by portal hypertension. Surgical management of portal hypertension varies depending on aetiology.
