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Diagnostic Methods of Cirrhosis and Portal Hypertension: Specifics of the Pediatric Population

  • Daniel H. Leung
  • Milton J. Finegold
  • Benjamin L. Shneider
Chapter

Abstract

The etiopathogenesis, biology and clinical course of pediatric liver diseases are distinct from that described in adults. There are also critical differences in the availability of disease-specific therapies and evidence supporting surveillance for varices and hepatobiliary cancer in children.

Cirrhosis in children is often a clinical, not histologic, diagnosis and is frequently equated with clinical features of portal hypertension. In light of the general desire to avoid invasive procedures in children, there is enhanced value in developing noninvasive methods to assess advancing fibrosis in children. Evolving preliminary information on noninvasive approaches in children exists, but caution should be exercised in utilization of adult-derived thresholds. Future characterization of these noninvasive approaches will be complicated by the potential inability to universally ground them in histology or portal pressure measurements. As such, correlation with key clinical outcomes will be critical.

Keywords

Biliary atresia Congenital hepatic fibrosis Cystic fibrosis Sclerosing cholangitis Children Noninvasive 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Daniel H. Leung
    • 1
  • Milton J. Finegold
    • 2
  • Benjamin L. Shneider
    • 1
  1. 1.Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of PediatricsBaylor College of Medicine, Texas Children’s HospitalHoustonUSA
  2. 2.Department of Pathology and ImmunologyBaylor College of MedicineHoustonUSA

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