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Prevost et al. published a systematic review evaluating the use of manual therapy for clinical conditions in the pediatric population in 2019. However, several methodological flaws in the conduct of the review limit the internal validity of its conclusions. We caution readers about the validity of the recommendations and suggest that the review not be used to inform the clinical management of pediatric patients. We hypothesized that portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) increases portal pressure and cause
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