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[Portal hypertension in chronic hepatitis (author's transl)]
Insights
Portal hypertension, a complication of chronic liver disease, increases with liver damage. Early detection and treatment of chronic hepatitis (CH) are crucial to prevent severe outcomes like esophageal varices bleeding.
Area of Science:
- Hepatology
- Gastroenterology
- Clinical Medicine
Context:
- Portal hypertension is a serious complication in chronic liver diseases.
- Elevated portal pressure is linked to life-threatening conditions like esophageal varices bleeding.
- Cirrhotic remodeling significantly increases portal pressure to critical levels.
Purpose:
- To measure portal and hepatic vein pressures in patients with chronic hepatitis (CH) using laparoscopic transhepatic manometry (LTM).
- To assess pressure changes in different stages of chronic hepatitis, from mild fibrosis to cirrhosis.
Summary:
- Laparoscopic transhepatic manometry (LTM) revealed elevated portal vein pressures in chronic hepatitis patients.
- Patients with chronic aggressive hepatitis (CAH) and cirrhosis showed higher portal pressures (19.9 mm Hg) compared to those with chronic persistent hepatitis (CPH) (17.7 mm Hg).
- Even with slight fibrosis, CAH patients exhibited increased portal pressure (18.8 mm Hg).
Impact:
- Highlights the importance of early detection and intensive treatment of chronic hepatitis (CH).
- Emphasizes the correlation between increasing portal hypertension and the risk of esophageal varices bleeding.
- Provides crucial data for understanding disease progression and managing patients with chronic liver inflammation.
Abstract:
Portal hypertension as the basis of threatening complications determines the subsequent fate of many patients with chronic inflammatory diseases of the liver. Normal values are exceeded considerably already in chronic hepatitis, but critical levels of pressure--with respect to the danger of bleeding from oesophageal varices--are only attained when cirrhotic remodelling is complete. With the aid of laparoscopic transhepatic manometry (LTM), we measured the levels of pressure in the branches of the portal vein and the hepatic vein in 23 patients suffering from chronic hepatitis (CH). In patients with chronic persistent hepatitis (CPH), the pressure in the portal vein was 17,7, in the hepatic vein 12,3 mm Hg (n = 4). In a group of 15 patients presenting with chronic aggressive hepatitis (CAH) with marked remodelling extending to cirrhosis, the average pressures were 19,9 and 11,8 mm Hg respectively; in four patients with CAH and, as yet, only slight fibrosis, the corresponding figures were 18,8 and 11,0 mm Hg respectively. In view of the recorded incidence of bleeding in 42 patients with complete hepatic cirrhosis, the early detection and intensive treatment of CH is of particular importance.