Vnitr Lek 1996, 42(10):696-699

[Portal hypertension--introduction to the problem].

M Brodanová: I. interní klinika 1. LF UK a VFN, Praha.

Portal hypertension is a condition with a permanently raised pressure in the portal area. The most frequent cause is restricted blood flow through some part of the circulation. Depending on the site of obstruction, we classify portal hypertension into prohepatic, hepatic and posthepatic. In adult age the most frequent form is the hepatic one associated with cirrhosis of the liver, in childhood prehepatic hypertension associated with thrombosis of the porta. The significance of portal hypertension is due in particular to its sequelaes. Among the most serious ones is the development of a collateral circulation with subsequent gastroesophageal varicosities. The latter involve the risk of rupture and massive haemorrhage into the gastrointestinal tract. The patient develops posthaemorrhagic shock. The author mentions the most important metabolic and cellular changes caused by shock. The importance of complications is emphasised. Haemorrhage is frequently followed by hepatic failure, which even nowadays is usually fatal. The author mentions also the risks of hypersplenism and emphasizes their participation in haemorrhage. In the introduction the author points out why wo much attention should be paid so portal hypertension and procedures influencing it.