Children's Hospital Colorado
Pediatric Liver Center

Portal Hypertension

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What is portal hypertension?

Portal hypertension is an increase in the blood pressure within the portal vein, a blood vessel that carries blood from the stomach, intestine, spleen and pancreas to the liver. This condition can lead to many complications and can require a liver transplant in severe cases.

What causes portal hypertension in children?

Portal hypertension can be caused by any of the following:

  • A blockage due to a blood clot (thrombosis)
  • A malformation of the portal vein itself
  • Scarring on the liver (cirrhosis)
  • Any liver disease that blocks the flow of blood through the liver

The increased pressure in the portal vein also causes pressure to increase in other veins. This increased pressure in the veins can force blood to back up into the splenic vein, causing the spleen to enlarge. Increased pressure in the veins of the intestines can cause diarrhea and bleeding of the gastrointestinal (GI) tract.

Portal hypertension can lead to the growth of new blood vessels called varices that connect blood flow from the GI tract, such as the intestine, to the general circulation, bypassing the liver. When this happens, toxins and nutrients that the liver would normally process can travel into the rest of the bloodstream.

Varices form when the body senses the increased portal vein pressure and tries to compensate. Varices are weaker than normal vessels and can bleed easily. They tend to grow around the esophagus, spleen, stomach and colon and can cause life-threatening bleeding in the digestive tract.

Who gets pediatric portal hypertension?

Children may develop portal hypertension if they have a blockage of the portal vein outside of a healthy liver, called extra-hepatic portal vein thrombosis. Portal hypertension also commonly occurs in children with severe liver disease.

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