Pediatric Transjugular Intrahepatic Portosystemic Shunts

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) creation offers potentially life-saving portal decompression regardless of patient age or size, but has been underutilized in pediatric patients to date. Experience has therefore been limited, and the full clinical benefit in this population is yet to be realized. Those wishing to embark on pediatric TIPSs would benefit not only from significant experience in adult TIPSs, but also from an awareness of challenges posed by the unique pediatric population. We herein review the etiologies and manifestations of portal hypertension more common in children, highlight some of the technical nuances of creating TIPSs in smaller anatomy, and summarize the existing literature on the topic. As extrahepatic portal vein occlusion (EHPVO) occurs with greater frequency in pediatric patients, special attention is paid to this condition and its associated challenges.

Successful surgical management of cardiac tamponade following direct intrahepatic portosystemic shunt in a child with Budd–Chiari syndrome: A potentially life-threatening situation

“…[ 5 ] Moreover, the experience of the interventional portosystemic shunts in children is limited. [ 6 ]…”