Nonsurgical treatments for portal hypertension in children.

The nonsurgical management of portal hypertension in infants and children has undergone dramatic changes with the advent of endoscopic injection sclerotherapy and variceal ligation. Additional newer therapeutic interventions include radiographic transhepatic obliteration of vessels and angiographic portosystemic shunts. Adjunctive drug therapy is helpful in selected cases. Physicians managing infants and children with varices must understand the nature of portal hypertension in younger patients and the limitations of the therapeutic modalities.