Clinical Gastroenterology Vol.15 No.5(1)

Theme Portal Hypertension
Title Causes and Classification of Portal Hypertension
Publish Date 2000/05
Author Kazuhiko Oho Second Department of Medicine, Kurume University School of Medicine
Author Atsushi Toyonaga Division of GI and Endoscopy, Kurume University School of Medicine
Author Michio Sata Second Department of Medicine, Kurume University School of Medicine
[ Summary ] The causes of portal hypertension in the West are mainly associated with alcoholism, in contrast, the most common etiology in Japan is to do with post-hepatitic cirrhosis. In relation to the sites which presumably offer resistance to portal venous blood flow, portal hypertensive states are classified into two types the "intra-hepatic" and the "extra-hepatic". Furthermore, the former is classified into three types the "pre-sinusoidal " (associated with idiopathic portal hypertension; IPH), the "sinusoidal" and the "post-sinusoidal" (associated with cirrhosis). The latter is classified into two types the "pre-hepatic" (associated with extra-hepatic portal obstructions; EHO) and the "post-hepatic" (associated with Budd-Chiari syndrome). By measuring the difference between portal pressure and wedged hepatic venous pressure (WHVP), the site of portal blockage may be detected. The pathogenesis of IPH, EHO and Budd-Chiari syndrome is still unclear.
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