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[Diagnostic utility of hepatic hemodynamics study in hepatoportal sclerosis]
S Alonso1, R Bañares, J Barrio
1Laboratorio de Hemodinámica Hepática, Sección de Hepatología. Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.
Aim:
To evaluate the diagnostic utility of catheterization of the suprahepatic veins in patients with suspected non-cirrhotic portal hypertension as well as to characterize the clinical features and evolution of this process.
Patients And Methods:
Hepatic hemodynamics studies, transjugular biopsy and venography were performed in seven patients with suspected non-cirrhotic portal hypertension. In all patients the combination of the three procedures gave the diagnosis of hepatoportal sclerosis, which was subsequently confirmed by direct portography and percutaneous or laparoscopic liver biopsy.
Results:
Three patients presented esophageal variceal bleeding at diagnosis. Only one patient required intrahepatic shunting due to refractory bleeding. None of the patients required surgical shunting or presented alterations in liver function.
Conclusions:
Hepatic hemodynamics study with transjugular biopsy and venography is an effective procedure in the diagnosis of hepatoportal sclerosis and in most cases invasive confirmatory tests are not required. The course of the disease is relatively benign if variceal bleeding is controlled. The treatment of choice in these patients is pharmacological and endoscopic.