The surgical care of infants and children with portal hypertension has been reported infrequently. It was our desire to add our experience to that already reported and to consolidate what appears to us to be the basic problems facing the surgeon in the diagnosis and care of these children.
The classification of Whipple22 with slight modification serves equally well in children as in adults.I. PrehepaticA. Obstruction of inferior vena cava—congenitalII. HepaticA. Portal cirrhosisB. Thrombosis of hepatic veins (Chiari's syndrome)III. PosthepaticA. Congenital1. Cavernomatous transformation of portal vein2. Congenital stricture and obliteration of portal veinB. Acquired thrombosis of portal vein or its tributaries1. Trauma2. Infection3. Idiopathic or spontaneous origin The posthepatic cases are the most distressing to the surgeon, and, although from a clinical standpoint they can be differentiated into congenital and acquired, they are too