This is a case of a 5 year-old male, 18.8 kg diagnosed with portal hypertension secondary to portal vein thrombosis from a previous umbilical vein catheterization during the neonatal period. The patient presented with recurrent hematemesis and melena requiring repeated hospital admissions and blood transfusions which started at 2 years of age. Esophago-gastroscopy initially confirmed the presence of bleeding esophageal and gastric varices. However, due to technical difficulties and challenges of endoscopy in a small child, variceal banding was not done. The patient was then referred to our institution for surgical management. Pre-operative abdominal CT angiography and abdominal doppler ultrasound were done to characterize the left renal vein, and splenic vein. Distal splenorenal shunt was done and intraoperative as well as post-operative courses were uneventful. Post-operative doppler ultrasound confirmed the patency of the distal splenorenal shunt. One month and 6 months post-operatively, surveillance esophago-gastroscopy revealed disappearance of the previously noted varices. There is also no note of recurrence of the upper gastrointestinal bleeding.