[Cirrhosis of the liver without portal hypertension (author's transl)]

A group of patients with "cirrhosis of the liver", confirmed by biotic examination, were first subjected to radiographic examination of the coeliac tripod so as to confirm the presence of porto-hepatic or portocaval shunts; the blocked suprahepatic pressure and the porto-hepatic gradient were then determined. The porto-hepatic gradient values showed high variability, ranging from normal values (4 mm Hg) to values of 24 or more mm Hg, characteristic of portal hypertension of high severity. This is confirmation of the possibility that a cirrhosis, even though with presence of collateral circulations, need not necessarily be linked to a hemodynamic situation of portal hypertension. The observation, then, of normal portal pressure in the most advanced stages of cirrhosis (3rd stage according to the ALPERT and MITRA classification) seems to indicate the tendency to normalization of the portal pressure values in evolution of the disease.