Portal hypertension (PHT) poses a significant clinical challenge in children, with management approaches varying widely across different medical centres, as previously reported by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Portal Hypertension Special Interest Group (PHT-SIG). This brief communication reviews the results of a follow-up questionnaire-based study carried out by the PHT-SIG to explore further management issues not covered in the initial survey. While most clinicians concur on key definitions and regularly use oesophagogastroduodenoscopy for both primary and secondary prophylaxis, notable differences remain in the application of non-selective beta-blockers. Liver and spleen stiffness measurements are increasingly employed as non-invasive markers of PHT, although no standardised paediatric thresholds currently exist. Practices concerning portal vein thrombosis and the indications for MesoRex shunt and interventional radiology also differ. Anticoagulation protocols following intervention are applied inconsistently. The findings highlight the necessity for prospective multicentre clinical trials to establish standardised, evidence-based guidelines, thereby harmonising the care provided to children with PHT.
Beyond consensus: Identifying divergences in the care of children with portal hypertension
Di Giorgio A.;
2026-01-01
Abstract
Portal hypertension (PHT) poses a significant clinical challenge in children, with management approaches varying widely across different medical centres, as previously reported by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Portal Hypertension Special Interest Group (PHT-SIG). This brief communication reviews the results of a follow-up questionnaire-based study carried out by the PHT-SIG to explore further management issues not covered in the initial survey. While most clinicians concur on key definitions and regularly use oesophagogastroduodenoscopy for both primary and secondary prophylaxis, notable differences remain in the application of non-selective beta-blockers. Liver and spleen stiffness measurements are increasingly employed as non-invasive markers of PHT, although no standardised paediatric thresholds currently exist. Practices concerning portal vein thrombosis and the indications for MesoRex shunt and interventional radiology also differ. Anticoagulation protocols following intervention are applied inconsistently. The findings highlight the necessity for prospective multicentre clinical trials to establish standardised, evidence-based guidelines, thereby harmonising the care provided to children with PHT.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
