The first step in treating your child is forming an accurate and complete diagnosis. Because portal hypertension can cause a variety of complications, your child’s doctor will likely already be on the lookout for signs such as gastrointestinal bleeding, enlargement of the spleen, the development of varices, and the presence of abdominal swelling (ascites).
Imaging technologies can provide a great deal of information on the anatomy and function of the portal vein and surrounding organs and vessels. Using ultrasound, a painless and non-invasive imaging technology, physicians can see the direction and speed of the blood flow through the portal vein. In addition, the technology lets them assess the state of the liver, spleen, and gallbladder, and also see whether varices have developed. Often, ultrasound is the first way in which “cavernous transformation of the portal vein” is diagnosed. The portal vein and related blood vessels can also be seen using other techniques, such as a special CT scan (called a “CTA” or “CT angiogram”) or magnetic resonance imaging (MRI).
If your child has portal hypertension, even if he or she has not yet had gastrointestinal bleeding, physicians may use an endoscope – a thin, flexible, lighted tube – to look for varices in the esophagus. If your child is old enough and can swallow a capsule, a wireless capsule endoscopy may be done instead. In this case, a tiny camera in a capsule sends digital pictures to a computer as the capsule itself goes down the esophagus.
If varices are bleeding, our physicians can also use an endoscope to deliver some forms of treatment aimed at controlling this complication.