pends on prompt and skillful medical and nursing care. Although a nurse may not encounter these children often, she should be familiar with the problem. Normally, blood from the digestive tract empties first into the portal system, or liver circulation, before returning to the heart via the inferior vena cava. If any major block exists along this portal pathway, back-up of blood and increased pressure develop below the blocked area, and portal hypertension results. The flow of blood through all the veins that normally empty into the portal system then reverses itself in an effort to form collateral channels back