Pediatric non-cirrhotic portal hypertension: Endoscopic outcome and perspectives from developing nations

Core Tip

Core Tip: The review discusses the natural history, endoscopic outcome, and management of non-cirrhotic causes of portal hypertension in children, especially in resource constraint developing nations. Extrahepatic portal vein obstruction is the most common cause of portal hypertension in developing countries. Endoscopic variceal ligation and sclerotherapy effectively eradicate the esophageal varices. Other complications require shunt surgery that ultimately reverses portal hypertension. Non-cirrhotic portal fibrosis has favourable outcomes in terms of variceal bleeding and mortality. Isolated congenital hepatic fibrosis (CHF) has a relatively good outcome. Liver transplantation is required when CHF is associated with Caroli’s disease, recurrent cholangitis, and decompensation. The presence of significant renal disease requires combined liver and kidney transplantation.