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For 14 years, from January 1973 to December 1986, 125 patients were diagnosed and operated because of portal hypertension at Department of Surgery, SNUH, among which 25patients had extrahepatic portal hypertension. The authors reviewed available clinical records of 21 patients with extrahepatic portal hypertension and obtained the following results. 1) The proportion of extrahepatic portal hypertension to total cases with portal hypertension was 18.5%. 2) The ratio of male to female was 1.6 : 1. Age distribution was 5? 41 years of age and 71.4% of patients was distributed in second and third decades. 3) The main clinical manifestation was hematemesis in 18 cases. Splenomegaly was present in 17 cases and 5 cases revealed hypersplenism. Other symptoms and signs were melena in 13 cases, abdominal pain in 5 cases, ascites in 3 cases, hepatomegaly in 3 cases, and easy bruisability in 2 cases. 4) The most frequent cause of extrahepatic portal hypertension was portal vein thrombosis in 16 cases and the locations of extrahepatic portal venous obstruction were cases which involved only portal vein and cases which involved splenic vein and superior mesenteric vein as well as portal vein. In 5 cases, the causes could not be found. 5) As a preoperative study, angiography was done in 14 cases and 12 cases suggested extrahepatic portal hypertension. Comparing this group with angiography*not-performed group, which it was unable to locate the site of venous obstruction and evaluate the severity of venous’ obstruction as weJl as the diagnosis was dependent on the indirect findings such as clinical and laboratory findings, the authors could make more excellent pre.Operative evaluation in angiography performed group. 6) The predisposing factors were present in 5 cases, among which omphalitis of neonatal period were in 3 cases and sepsis of infantile period in 1 case, and the other one was pancreatitis which caused portal vein thrombosis. * 본 논문은 1987년도 서울대학교병원 특진연구비의 보조로 이루어진 것임. ㅡ 678 ? ㅡ간의 문叫 압 항진증의 임 상적 연구ㅡ 7) The portal, venous pressure was measured during: operation in 18 cases. 55.6% of cases showed 30ㅇ?500mmH20 in PVP and pressure decrement after operation averaged 143 mmHaO. In cases with higher pre-operative portal verxus piesime, no i^ conspicuous decompressive effect of operation was noticed. 8) Twenty-four operations were done in 21 patients with extrahepatic portal hypertension. The operations were splenorenal shunt in 9 cases, ir*esocaval shunt! in 4 cases, splenectomy in 4 cases, coronocaval shunt in 3 cases, Sugiuia’s operation in 2 cases, Warren shunt in 1 case and portacaval shunt in 1 case. 9) The operative mortality was 0% and complications were rethrcirtosis in 1 case, rebleeding in 6 cases, post shunt encephalopathy in 1 caae, pancreatic pceudccyst in 1 case and reflux alkaline esophagitis in 2 cases.
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