Cirrhosis & Portal Hypertension

The scar tissue can make it difficult for blood to flow to the liver through the portal vein (a major blood vessel). When blood flow slows down in the portal vein, the pressure from the vein backs up. This pressure is called portal hypertension.

When portal vein blood backs up into other vessels, they become swollen. The stretched vessels are called varices and occur in the esophagus and sometimes stomach and intestine. They develop thin walls caused by the unusual high-pressure blood flow and can easily break open. Bleeding from a broken blood vessel (variceal bleeding) is serious and can be life-threatening.

When blood does not flow normally through the portal vein, it returns to the heart using other blood vessels. This means toxins remain in the body because blood cannot flow through the liver to be cleaned.

Symptoms of cirrhosis and portal hypertension include:

• Ascites (fluid in the abdomen that causes abdominal swelling)
• Dark brown urine
• Itchiness of the skin
• Jaundice (yellowing of the skin and whites of the eyes)
• Loss of appetite
• Nausea
• Red palms
• Vomiting blood
• Weakness and fatigue
• Encephalopathy (unclear thinking)

Diagnosis of Cirrhosis & Portal Hypertension

If your child’s symptoms indicate possible cirrhosis and portal hypertension, a pediatric gastroenterologist will complete the following exams to confirm a diagnosis:

• Physical exam. The doctor will examine your child and look for:
  • An enlarged liver or spleen
  • Excess fluid in the tissues lining the abdomen
  • Widened (dilated) veins in the abdomen wall
  • Jaundice
  • Reddened palms
  • Red, spider-like blood vessels on the skin
• Liver biopsy. A liver biopsy is occasionally done to confirm cirrhosis or to evaluate for causes.