RT Book, Section
A1 Nathan, Jaimie D.
A1 Campbell, Kathleen M.
A1 Ryckman, Frederick C.
A1 Alonso, Maria H.
A1 Tiao, Greg M.
A2 Ziegler, Moritz M.
A2 Azizkhan, Richard G.
A2 Allmen, Daniel von
A2 Weber, Thomas R.
SR Print(0)
ID 1100952637
T1 Portal Hypertension
T2 Operative Pediatric Surgery, 2e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-162723-8
LK accesspediatrics.mhmedical.com/content.aspx?aid=1100952637
RD 2024/04/19
AB Etiology  of  portal  hypertension  may  be  classified  as  prehepatic,  intrahepatic,  or  posthepatic.Extrahepatic  portal  vein  obstruction  (EPVO)  is  the  most  common  type  of  prehepatic  obstruction.Most  cases  of  acute  variceal  bleeding  can  be  controlled  with  fluid  resuscitation,  correction  of  coagulopathy,  and  pharmacologic  support.Octreotide  is  the  most  commonly  used  pharmacologic  intervention  in  the  management  of  acute  variceal  bleeding.Upper  endoscopy  is  an  important  intervention  for  both  diagnostic  and  therapeutic  purposes  in  acute  variceal  bleeding.Endoscopic  sclerotherapy  or  band  ligation  can  be  used  to  control  refractory  variceal  bleeding.Classification  of  portosystemic  shunts:  nonselective  shunt,  selective  shunt,  direct  reconstruction  of  portal  circulation.H-type  mesocaval  shunt  is  the  most  commonly  used  nonselective  shunt.The  most  common  selective  shunt  is  the  distal  splenorenal  shunt.EPVO  is  optimally  managed  by  the  mesentericoportal  shunt  (Rex  shunt).Transjugular  intrahepatic  portosystemic  shunt  (TIPS)  may  be  used  as  a  bridge  for  liver  transplantation  in  patients  with  intrinsic  liver  disease  who  have  acute  unresponsive  variceal  bleeding.If  significant  portal  hypertensive  complications  are  accompanied  by  progressive  hepatic  synthetic  failure,  liver  transplantation  is  preferred.