Idiopathic protal hypertension is a clinical disorder of unknown etiology, charaterized by splenomegaly, anemia and portal hypertension often with bleeding varices. Diagnostic criterias of this syndrome include normal or near-normal liver
function
tests
, varices demonstrated by endoscopy, decrease in one or more formed blood elements, patent extrahepatic portal vein and hepatic veins, grossly noncirrhotic liver surface, and elevated portal pressure. The prognosis is excellent if variceal
bleeding
is
adequately controlled or prevented.
Authers experienced twenty cases of idiopathic portal hypertension in recent ten years. There were fifteen men and five women, and average age of the patients was twenty eight.. Chief complaints on admission were variceal bleeding in sixteen
patients,
and palpable spleen and upper abdominal pain in four. On examination, all patients reveled splenomegaly, gastroesophageal varices, pancyotopenia and normal liver function tests. Splenoportography showed patent and dilated splenoprtal vein with
well
developed collaterals. Portal pressure was over 310 mmH2O. Gross and microscopic features of the liver tissue were normal, but electron microscopic examination demonstrated widening and depostion of collagen bundles in the space of Disse. The
surgical
procedures included sixteen transabdominal esophageal transections, two proximal splenorenal shunts, one H-graft mesocaval shunt an done splenectomy. Postoperatively all the patients survived, and there was no recurrent bleeding.
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