Abstract
Two types of portal venous shunting procedures designed primarily for small children are discussed. The central splenorenal anastomosis would appear to be superior to the conventional splenorenal shunt as judged by the critical factor of freedom from further upper gastrointestinal bleeding. The inferior vena cava to superior mesenteric vein shunt is designed for patients in whom the splenic vein cannot be used. The results with these two types of shunts are sufficiently encouraging so that we prefer to perform shunts in average sized children over four years of age with bleeding varices rather than more complex, direct local procedures designed to obliterate the varices.
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