Portal Hypertension and Hepatic Coma

Abstract

Medical treatment to control hyperammonemia and to insure maintenance of normal DNA synthetic capacity may prevent further deterioration of hepatic reserve in patients with portal hypertension and coma in whom etiologic mechanisms can be controlled. A portacaval shunt is indicated in selected cases of portal hypertension to control bleeding from esophageal varices in spite of its capacity to precipitate mental aberrations and its inability to alter the overall prognosis in diseases of the liver.