Investigative studies in portal hypertension

Portal hypertension usually results from progressive chronic liver disease and is manifested by the development of communications between portal and systemic circulation, termed collateral vessels. Bleeding from collateral vessels in the submucosa of the esophagus and stomach is a potentially fatal condition that is frequently treated with either endoscopic sclerotherapy or endoscopic variceal ligation; portal-systemic shunts are placed when these treatments fail. There are a wide range of investigative studies available to detect portal hypertension and to assess abnormalities in the portal circulation. These are helpful to determine treatment strategies for primary prophylaxis of variceal hemorrhage and to prevent rebleeding. A number of research investigations are designed to understand the mechanisms for bleeding from varices and to determine the pathophysiological basis for treatment.