Beyond Varices: Complications of Cirrhotic Portal Hypertension in Pediatrics

Anna M. Banc-Husu; Henry Shiau; Peace Dike; Benjamin L. Shneider

doi:10.1055/s-0042-1759613

Seminars in Liver Disease, Inhaltsverzeichnis

Semin Liver Dis 2023; 43(01): 100-116
DOI: 10.1055/s-0042-1759613

Review Article

Beyond Varices: Complications of Cirrhotic Portal Hypertension in Pediatrics

Anna M. Banc-Husu

¹Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas

,

Henry Shiau

²Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama

,

Peace Dike

¹Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas

,

Benjamin L. Shneider

¹Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas

› Institutsangaben

Abstract

Complications of cirrhotic portal hypertension (PHTN) in children are broad and include clinical manifestations ranging from variceal hemorrhage, hepatic encephalopathy (HE), ascites, spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS) to less common conditions such as hepatopulmonary syndrome, portopulmonary hypertension, and cirrhotic cardiomyopathy. The approaches to the diagnosis and management of these complications have become standard of practice in adults with cirrhosis with many guidance statements available. However, there is limited literature on the diagnosis and management of these complications of PHTN in children with much of the current guidance available focused on variceal hemorrhage. The aim of this review is to summarize the current literature in adults who experience these complications of cirrhotic PHTN beyond variceal hemorrhage and present the available literature in children, with a focus on diagnosis, management, and liver transplant decision making in children with cirrhosis who develop ascites, SBP, HRS, HE, and cardiopulmonary complications.

Keywords

cirrhosis - complications of portal hypertension - children - ascites - transplant

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