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.