Portal hypertension in children. An experience of 33 cases.
The pathology, treatment and progress of 33 children with portal hypertension are reviewed. There were 20 patients with extra-hepatic portal obstruction (EHB) and 13 with intra-hepatic obstruction (IHB). The lesion in all the EHB was a block in the portal vein: in IHB it was a post-hepatitis cirrhosis in two cases and in the others a congenital abnormality. Treatment was surgical in 32 patients. The prognosis in EHB is good and long survival after operation was the rule. In IHB the survival depended upon the type and severity of the hepatic disorder and the incidence of recurrent bleeding. The frequency of recurrent bleeding was found to vary with the operation performed being greatest after splenectomy alone or with devascularisation, and least after lieno-renal anastomosis. The follow-up ranged from one year to more than 28 years.