Surgical management of portal hypertension in childhood: long-term results

Archives of Surgery
E W Fonkalsrud

Abstract

This retrospective clinical review of reports by several authors of 253 children with extrahepatic (EPH) and 87 children with intrahepatic (IPH) portal hypertension who have undergone operations for variceal hemorrhage presents the long-term follow-up based on the type of management provided. Shunt operations are preferred over direct operative procedures in patients with EPH when mesenteric veins suitable for shunting are available. Cavomesenteric shunts provide the best permanent relief from variceal bleeding. Partial esophagogastrectomy with colon interposition or poral-azygous disconnection are the best operations when a shunt is not technically feasible, almost half of the patients obtaining long-term relief from bleeding. More than one fourth of the children with EPH can be managed successfully for long periods nonoperatively. For children with variceal bleeding due to IPH, the underlying liver disease determines the prognosis. The ultimate mortality is approximately the same regardless of whether a shunt or direct procedure is performed.

Citations

Jul 24, 2013·International Journal of Hepatology·N ChaudharyS Nundy
Apr 1, 1984·Archives of Disease in Childhood·R A SpenceH W Rodgers
Nov 1, 1994·Archives of Disease in Childhood·P D LostyE J Guiney
Sep 15, 2004·Journal of Clinical Microbiology·Lucia PacificoClaudio Chiesa
Apr 1, 1985·World Journal of Surgery·J ValayerJ Broto
Jun 26, 2002·Journal of the American College of Surgeons·Marshall J OrloffSusan L Orloff
Jan 1, 1985·Scandinavian Journal of Gastroenterology. Supplement·N Stray, O Fausa
Jul 1, 1983·American Journal of Surgery·J B Atkinson, M M Woolley
Dec 1, 1985·Journal of Pediatric Surgery·D W VaneH W Clatworthy
Feb 1, 1984·Journal of Pediatric Surgery·E R HowardA P Mowat
Dec 1, 1983·Journal of Pediatric Surgery·R A SuperinaB Shandling
Jul 1, 1989·The Journal of Pediatrics·E HassallS Dorney
Nov 1, 1983·The Journal of Pediatrics·F AlvarezD Alagille
Aug 13, 2003·Pediatrics International : Official Journal of the Japan Pediatric Society·Semra SökücüGünay Saner
Mar 1, 1994·Journal of Pediatric Surgery·T H RenardR N McClelland
Jan 22, 2008·Journal of Pediatric Surgery·Anthony C ChinRiccardo A Superina
Mar 1, 1987·Journal of Pediatric Surgery·D M BurgeS J Karran
Jan 21, 2004·Journal of Gastroenterology and Hepatology·Showkat Ali ZargarHakim Mohamad Shafi
Jul 1, 1987·The British Journal of Surgery·D KahnP Bornman
May 1, 1988·The British Journal of Surgery·E R HowardA P Mowat
Mar 1, 1989·Journal of Gastroenterology and Hepatology·J B DilawariB N Walia
Feb 1, 1990·Gut·Y K ChawlaB N Walia
Jan 1, 1997·The British Journal of Dermatology·C P ChenB F Chen
Oct 21, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Heung Bae KimSteven J Fishman
Jan 1, 1997·Journal of Pediatric Gastroenterology and Nutrition·S K YachhaA Khanduri
Jul 1, 1985·Pediatric Annals·P F Whitington
Oct 1, 1982·Journal of Pediatric Surgery·J R LillyG Stellin

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.