Pediatric liver cirrhosis interventional procedures: from biopsy to transjugular intrahepatic portosystemic shunt

Pediatr Radiol. 2023 Apr;53(4):727-738. doi: 10.1007/s00247-022-05492-7. Epub 2022 Sep 19.

Abstract

Cirrhosis is a complex diffuse process whereby the architecture of the liver is replaced by abnormal nodules because of the presence of fibrosis. Several pediatric diseases such as extrahepatic portal vein obstruction, biliary atresia, alpha-1-antitrypsin deficit and autoimmune hepatitis can lead to cirrhosis and portal hypertension in children. In this article the authors describe interventional radiology procedures that can facilitate the diagnosis and treatment of diseases associated with liver cirrhosis and portal hypertension in the pediatric population. These procedures include image-guided liver biopsy, mesenteric-intrahepatic left portal vein shunts, balloon-occluded retrograde transvenous obliteration, transjugular intrahepatic portosystemic shunts and splenic embolization.

Keywords: Biopsy; Children; Cirrhosis; Embolization; Interventional radiology; Liver; Portal hypertension; Transjugular intrahepatic portosystemic shunt.

MeSH terms

  • Child
  • Humans
  • Hypertension, Portal* / diagnostic imaging
  • Hypertension, Portal* / surgery
  • Image-Guided Biopsy
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnostic imaging
  • Portal Vein
  • Portasystemic Shunt, Transjugular Intrahepatic* / methods
  • Treatment Outcome