Portal pressure and collaterals in cirrhotic patients.
Percutaneous transhepatic portography and portal pressure measurements were used to investigate portal haemodynamics. In 33 normal controls portal pressure was 12.3 +/- 3 cm H2O, while in 69 cirrhotics it was 33.7 +/- 6 cm H2O. Reversed portal flow was demonstrated in 48% of the cirrhotic patients. Portal pressure was significantly higher (p less than 0.01) in patients (n = 48) with bleeding gastroesophageal varices (36.2 +/- 5 cm H2O) than in nonbleeding patients (n = 11) who had large collaterals but no demonstrable gastroesophageal varices (31.1 +/- 5 cm H2O). A third group of nonbleeding cirrhotic patients (n = 10) with significantly (p less than 0.01) elevated portal pressure (24.8 +/- 2 cm H2O) but scantly formed collaterals and no demonstrable gastroesophageal varices could be separated. Caudally directed collaterals lowered the portal pressure protecting the patients from bleeding. However, during the follow-up time most of nonbleeding patients succumbed from liver insufficiency.
D000328:Adult; D000368:Aged; D003097:Collateral Circulation; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006439:Hemodynamics; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000601:surgery; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D011172:Portography; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D013164:Splenorenal Shunt, Surgical; D014690:Venous Pressure