The Treatment of Portal Hypertension

Abstract

Portal hypertension, which may be intra-hepatic or extrahepatic, is a serious disease. Intrahepatic portal obstruction is usually due to cirrhosis. In portal hypertension, varices between portal and systemic circulations develop. Varices in the lower end of the esophagus are most important, because of the danger of ulceration and massive hemorrhage. Severe hemorrhage in the patient is dangerous because of fatal exsanguination and also because of the possibility of development of liver necrosis subsequent to anoxia during the period of hypotension.

Although temporary expedient procedures may be used to control bleeding from esophageal varices, the only definite procedure is operation which shunts the blood from the portal system into the systemic venous system.