Technical difficulties usually arise in infants when the vein size is too small for stenting. In 14 children with Budd-Chiari syndrome, we could perform radiological intervention successfully in 11; the procedure failed due to small vessel size in 3 patients.

ALA presenting as liver failure is rare and is not because of hepatocyte dysfunction, but due to compromised blood flow either from portal vein, hepatic vein or IVC compression, as was seen in our patient. Literature is scarce in the form of clinical case reports or imaging studies, documenting portal vein thrombosis in an ALA as a cause of liver failure.

Chronic mesenteric ischaemia is not an uncommon disorder. It is associated with high morbidity and mortality. We report two cases of chronic mesenteric ischaemia managed effectively with endovascular therapy with no morbidity and good long term pain relief.

We report a 5-year-old girl with congenital hepatic fibrosis who presented with clubbing and cyanosis. Four weeks after living-related liver transplantation, she had normal blood gases and reduction in shunting to 7% on macroaggregated albumin scan.