For children with EHPVO and an enlarged spleen, treatment focuses on reducing pressure in the portal vein and preventing complications. Key options include: 1. Medications: Beta-blockers (such as propranolol) may be used to help lower blood pressure in the veins. 2. Endoscopic Therapy: Procedures like band ligation (EVL) prevent or manage bleeding from swollen veins (varices). 3. Surgery: A bypass surgery, particularly the Rex shunt (mesoportal bypass), is highly effective in children. It restores normal blood flow to the liver and can significantly reduce spleen size. Rest assured, with proper medical management, children with EHPVO can lead active, normal lives. Please discuss these options with your pediatric gastroenterologist.