Surgical treatment of portal hypertension in children

Experience with the surgical management of portal hypertension in 16 children has been carefully analysed. Haematemesis and melaena were the commonest presentation. The site of obstruction was extra-hepatic in 11 patients and intrahepatic in five patients. Abnormal neonatal history was found in only two patients. Gastroscopy and trans-splenic portography were the most helpful diagnostic procedures. Conservative treatment controlled the vast majority of bleeding episodes, occasionally porto-systemic disconnection was required to stop the continous bleeding. Cavo-mesenteric shunt [end-to-side] was found to give satisfactory defenitive result. Ligation of splenic artery is safe and useful method; it can replace splenectomy