{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T23:31:48Z","timestamp":1794267108135,"version":"4.9.0"},"reference-count":51,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:p>Portal hypertension (PHT), defined as raised intravascular pressure in the portal system, is a complication of chronic liver disease or liver vascular occlusion. Advances in our ability to diagnose and monitor the condition but also predict the risk of gastrointestinal bleeding have enabled us to optimise the management of children with PHT either at a surveillance or at a postbleeding stage. A consensus among paediatric centres in the classification of varices can be beneficial in streamlining future paediatric studies. New invasive (endoscopic and surgical procedures) and non-invasive (pharmacotherapy) techniques are currently used enabling clinicians to reduce mortality and morbidity in children with PHT.<\/jats:p>","DOI":"10.1136\/archdischild-2015-310022","type":"journal-article","created":{"date-parts":[[2017,8,16]],"date-time":"2017-08-16T20:50:24Z","timestamp":1502916624000},"page":"186-191","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":53,"title":["Portal hypertension and its management in children"],"prefix":"10.1136","volume":"103","author":[{"given":"Tassos","family":"Grammatikopoulos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick James","family":"McKiernan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Dhawan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,8,16]]},"reference":[{"key":"2020050712433856000_103.2.186.1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31817b6eea"},{"key":"2020050712433856000_103.2.186.2","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.3748\/wjg.v18.i11.1176","article-title":"Management of portal hypertension in children","volume":"18","author":"Gugig","year":"2012","journal-title":"World J Gastroenterol"},{"key":"2020050712433856000_103.2.186.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"2020050712433856000_103.2.186.4","doi-asserted-by":"crossref","first-page":"III1","DOI":"10.1136\/gut.46.suppl_3.iii1","article-title":"UK guidelines on the management of variceal haemorrhage in cirrhotic patients. British Society of Gastroenterology","volume":"46","author":"Jalan","year":"2000","journal-title":"Gut"},{"key":"2020050712433856000_103.2.186.5","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/MPG.0000000000000822","article-title":"Interobserver Agreement on Endoscopic classification of Oesophageal Varices in Children","volume":"61","author":"D\u2019Antiga","year":"2015","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.6","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12824"},{"key":"2020050712433856000_103.2.186.7","doi-asserted-by":"publisher","DOI":"10.1136\/gut.28.10.1193"},{"key":"2020050712433856000_103.2.186.8","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1097\/MPG.0000000000000710","article-title":"Progression to high-risk gastroesophageal varices in children with biliary atresia with low-risk signs at first endoscopy","volume":"60","author":"Duch\u00e9","year":"2015","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.9","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.jhep.2016.09.006","article-title":"Portal hypertension in children: High-risk varices, primary prophylaxis and consequences of bleeding","volume":"66","author":"Duch\u00e9","year":"2017","journal-title":"J Hepatol"},{"key":"2020050712433856000_103.2.186.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(97)90611-4"},{"key":"2020050712433856000_103.2.186.11","doi-asserted-by":"crossref","unstructured":"Shneider BL , de Ville de Goyet J , Leung DH , et al . Primary prophylaxis of variceal bleeding in children and the role of MesoRex Bypass: summary of the Baveno VI Pediatric Satellite Symposium. Hepatology 2016;63.doi:10.1002\/hep.28153","DOI":"10.1002\/hep.28153"},{"key":"2020050712433856000_103.2.186.12","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1053\/j.gastro.2010.07.004","article-title":"Prognostic value of endoscopy in children with biliary atresia at risk for early development of varices and bleeding","volume":"139","author":"Duch\u00e9","year":"2010","journal-title":"Gastroenterology"},{"key":"2020050712433856000_103.2.186.13","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/MPG.0b013e318282a22c","article-title":"Assessment of risk of bleeding from esophageal varices during management of biliary atresia in children","volume":"56","author":"Wanty","year":"2013","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.14","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.115967"},{"key":"2020050712433856000_103.2.186.15","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1016\/S0022-3468(03)00181-7","article-title":"Endoscopic ligation of esophageal varices for prophylaxis of first bleeding in children and adolescents with portal hypertension: preliminary results of a prospective study","volume":"38","author":"Celi\u0144ska-Cedro","year":"2003","journal-title":"J Pediatr Surg"},{"key":"2020050712433856000_103.2.186.16","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1097\/MPG.0b013e318205993a","article-title":"Primary prophylaxis of variceal hemorrhage in children with portal hypertension: a framework for future research","volume":"52","author":"Ling","year":"2011","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.17","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/S0022-3476(97)70043-X","article-title":"Transjugular intrahepatic portosystemic shunts (TIPS) in children","volume":"131","author":"Heyman","year":"1997","journal-title":"J Pediatr"},{"key":"2020050712433856000_103.2.186.18","first-page":"217","article-title":"Presentation and natural history of variceal bleeding in patients with portal hypertension due to extrahepatic portal venous obstruction","volume":"22","author":"Shah","year":"2003","journal-title":"Indian J Gastroenterol"},{"key":"2020050712433856000_103.2.186.19","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1080\/gas.37.7.807.811","article-title":"Intestinal permeability and absorptive capacity in children with portal hypertension","volume":"37","author":"Taylor","year":"2002","journal-title":"Scand J Gastroenterol"},{"key":"2020050712433856000_103.2.186.20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.01830.x"},{"key":"2020050712433856000_103.2.186.21","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1111\/liv.12791","article-title":"Hepatopulmonary syndrome and portopulmonary hypertension: recent knowledge in pathogenesis and overview of clinical assessment","volume":"35","author":"Raevens","year":"2015","journal-title":"Liver Int"},{"key":"2020050712433856000_103.2.186.22","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840150210"},{"key":"2020050712433856000_103.2.186.23","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1046\/j.1440-1746.2001.02392.x","article-title":"Coagulation profile and platelet function in patients with extrahepatic portal vein obstruction and non-cirrhotic portal fibrosis","volume":"16","author":"Bajaj","year":"2001","journal-title":"J Gastroenterol Hepatol"},{"key":"2020050712433856000_103.2.186.24","doi-asserted-by":"crossref","first-page":"6177","DOI":"10.3748\/wjg.v18.i43.6177","article-title":"Portal biliopathy","volume":"18","author":"Chattopadhyay","year":"2012","journal-title":"World J Gastroenterol"},{"key":"2020050712433856000_103.2.186.25","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181c15ef8"},{"key":"2020050712433856000_103.2.186.26","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1097\/MPG.0000000000001423","article-title":"King\u2019s Variceal Prediction Score: A Novel Noninvasive Marker of Portal Hypertension in Pediatric Chronic Liver Disease","volume":"64","author":"Witters","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.27","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1097\/MPG.0000000000001423","article-title":"King\u2019s variceal prediction score: a novel non-invasive marker of portal hypertension in paediatric chronic liver disease","volume":"64","author":"Witters","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.28","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1016\/j.jpedsurg.2015.02.007","article-title":"Prediction of esophageal varices in biliary atresia: Derivation of the \"varices prediction rule\", a novel noninvasive predictor","volume":"50","author":"Isted","year":"2015","journal-title":"J Pediatr Surg"},{"key":"2020050712433856000_103.2.186.29","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1016\/j.jpedsurg.2006.08.022","article-title":"Pediatric gastroesophageal varices: treatment strategy and long-term results","volume":"41","author":"Mitsunaga","year":"2006","journal-title":"J Pediatr Surg"},{"key":"2020050712433856000_103.2.186.30","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/00005176-199005000-00003","article-title":"Endoscopic sclerotherapy of esophageal varices in infants and children","volume":"10","author":"Thapa","year":"1990","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.31","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.35278"},{"key":"2020050712433856000_103.2.186.32","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1002\/bjs.1800750504","article-title":"Assessment of injection sclerotherapy in the management of 152 children with oesophageal varices","volume":"75","author":"Howard","year":"1988","journal-title":"Br J Surg"},{"key":"2020050712433856000_103.2.186.33","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1016\/0016-5085(91)90403-8","article-title":"A prospective controlled study of the risk of bacteremia in emergency sclerotherapy of esophageal varices","volume":"101","author":"Ho","year":"1991","journal-title":"Gastroenterology"},{"key":"2020050712433856000_103.2.186.34","first-page":"31","article-title":"Propranolol for primary and secondary prophylaxis of variceal bleeding in children with cirrhosis","volume":"42","author":"Ozsoylu","year":"2000","journal-title":"Turk J Pediatr"},{"key":"2020050712433856000_103.2.186.35","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1097\/MPG.0b013e318205993a","article-title":"Primary prophylaxis of variceal hemorrhage in children with portal hypertension: a framework for future research","volume":"52","author":"Ling","year":"2011","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.36","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/MPG.0b013e318267c334","article-title":"Endoscopic and pharmacological secondary prophylaxis in children and adolescents with esophageal varices","volume":"56","author":"dos Santos","year":"2013","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.37","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.01.004"},{"key":"2020050712433856000_103.2.186.38","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1053\/j.gastro.2016.03.015","article-title":"A New treatment for Portal hypertension?","volume":"150","author":"Rockey","year":"2016","journal-title":"Gastroenterology"},{"key":"2020050712433856000_103.2.186.39","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.1016\/S0022-3468(03)00520-7","article-title":"Extrahepatic portal hypertension treated by anastomosing inferior mesenteric vein to left portal vein at rex recessus","volume":"38","author":"Ate\u015f","year":"2003","journal-title":"J Pediatr Surg"},{"key":"2020050712433856000_103.2.186.40","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/j.jpedsurg.2013.10.029","article-title":"Intrahepatic portal venous systems in children with noncirrhotic prehepatic portal hypertension: anatomy and clinical relevance","volume":"49","author":"Bertocchini","year":"2014","journal-title":"J Pediatr Surg"},{"key":"2020050712433856000_103.2.186.41","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1002\/hep.28153","article-title":"Primary prophylaxis of variceal bleeding in children and the role of MesoRex Bypass: summary of the Baveno VI Pediatric Satellite Symposium","volume":"63","author":"Shneider","year":"2016","journal-title":"Hepatology"},{"key":"2020050712433856000_103.2.186.42","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1097\/MPG.0b013e3182490c05","article-title":"Feasibility and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in children","volume":"54","author":"Di Giorgio","year":"2012","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.43","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1097\/MPG.0b013e318213be81","article-title":"Variation in care for children with esophageal varices: a study of physicians', patients', and families' approaches and attitudes","volume":"52","author":"Gana","year":"2011","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.44","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1053\/j.sempedsurg.2012.05.004","article-title":"Medical management of esophageal varices and portal hypertension in children","volume":"21","author":"D\u2019Antiga","year":"2012","journal-title":"Semin Pediatr Surg"},{"key":"2020050712433856000_103.2.186.45","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.08.049"},{"key":"2020050712433856000_103.2.186.46","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2012.01652.x"},{"key":"2020050712433856000_103.2.186.47","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2006.00597.x"},{"key":"2020050712433856000_103.2.186.48","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1097\/MPG.0b013e3182042917","article-title":"Stomal varices manifestation of portal hypertension in advanced intestinal failure-associated liver disease","volume":"52","author":"Iyer","year":"2011","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2020050712433856000_103.2.186.49","doi-asserted-by":"publisher","DOI":"10.1177\/1076029608322549"},{"key":"2020050712433856000_103.2.186.50","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1586\/17474124.2015.993610","article-title":"Advances in the management of childhood portal hypertension","volume":"9","author":"McKiernan","year":"2015","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"2020050712433856000_103.2.186.51","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.05.002"}],"container-title":["Archives of Disease in Childhood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2015-310022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T06:58:50Z","timestamp":1601103530000},"score":1,"resource":{"primary":{"URL":"https:\/\/adc.bmj.com\/lookup\/doi\/10.1136\/archdischild-2015-310022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,16]]},"references-count":51,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,1,19]]},"published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1136\/archdischild-2015-310022"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2015-310022","relation":{},"ISSN":["0003-9888","1468-2044"],"issn-type":[{"value":"0003-9888","type":"print"},{"value":"1468-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,16]]}}}