[Dynamics and mental disorders in patients with portal hypertension after surgical treatment]

On the basis of the clinical, experimental-psychological and electroencephalographic examinations of 173 patients with portal hypertension (intrahepatic--110 and extrahepatic--63) the authors elucidated the regularities of the formation of mental disorders, their clinical characteristics and the course following surgical treatment. The asthenic syndrome with marked vegetative disturbances was the most prominent feature in the clinical picture. Patients with hepatic cirrhosis were characterized by a more severe asthenia and greater intensity of vegetative symptomatology as compared to patients with an extrahepatic form of portal hypertension. Characteristic of psychotic disorders in liver cirrhosis was severity of the psychoorganic syndrome. Personality shifts with the predominance of explosiveness, epilepsy- and paranoia-like tendencies grow with disease progression. Surgical treatment by constructing vascular anastomoses occasionally leads to intensification of the psychoorganic syndrome in cirrhosis patients and to its appearance in patients with extrahepatic portal hypertension, which calls for the development of more clear-cut indications for such surgery.