JPGN Journal Club: March 2026: Biomarkers and Risk Stratification for Varices in Children with Portal Hypertension

A round of applause, dear readers: We’ve made it into, good Heavens, 2026! Breasted the tape? Or limped across the finish line? No matter. To mis-quote Scripture, that is of course Stephen Sondheim: We’re still here. Among the “we,” and our lodestar, is Dr Jake Mann. He’s selected two articles for consideration: From Jezequel M et al., in work done at Lille, J Pediatr Gastroenterol Nutr brings us – Splenic stiffness does not predict esophageal varices in children with portal hypertension; and from a cluster of Parisian institutions, by Grimaud E et al. and published in Hepatology – Serum bile acid levels predict the development of portal hypertension and high-risk esophageal varices following successful Kasai in biliary atresia. In short: How to foretell the variceal future. What sorts of cohorts were assembled, and what data were collected? How were those data analysed? All-comers in Lille, in Paris persons with a certain disorder treated in a certain way with a certain age and meeting certain clinical criteria… A lot to sort out here, and the comparisons and contrasts are better listened to than read, you’ll agree. Or: Back to Sondheim, in the tale of Sweeney Todd, the demon barber of Fleet Street, who shaved the faces of gentlemen / Who never thereafter were heard of again… What happened next?Well, that’s the play –And he wouldn’t want us to give it away. Happy listening! Enjoy ESPGHAN Journal Club – enjoy the play! Literature Grimaud E et al. Serum bile acid levels predict the development of portal hypertension and high-risk esophageal varices following successful Kasai in biliary atresia. Hepatology 2025 Oct 23. DOI: 10.1097/HEP.0000000000001592. Online ahead of print. PMID: 41129338 Jezequel M et al. Splenic stiffness does not predict esophageal varices in children with portal hypertension. J Pediatr Gastroenterol Nutr 2026 Jan; 82(1):156–164. DOI: 10.1002/jpn3.70247. Epub 2025 Oct 27. PMID: 41144851. PMCID: PMC12780471