Extrahepatic Portal Hypertension

A retrospective analysis of 19 patients with esophagogastric or intestinal varices secondary to extrahepatic portal hypertension was conducted. Nine patients had onset of bleeding during childhood. In six of eight pediatric patients in whom a shunt was performed no major bleeding occurred during the follow-up period. In seven adults with pure extrahepatic portal hypertension the four shunting procedures effected permanent control of bleeding. In two of three adults in whom portal vein thrombosis was associated with liver disease, shunting was successful. An emergency procedure was infrequently required. Multiple recurrences of bleeding episodes prior to decompression was the rule. Postshunt encephalopathy was never seen. In those patients in whom a shunt thrombosed or could not be performed, recurrent bleeding occurred uncommonly, and was readily managed to bedrest and transfusion.