| Theme |
Portal Hypertension |
| Title |
Causes and Classification of Portal Hypertension |
| 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. |