The author studied the relation between portal pressure and histopathology of the Liver in 5l cases needing upper abdominal operation at Dept. of Surgery, College of Medicine. P.N.U., During the period from Jan., 1960 to July, 1960.
Clinically, most of the cases were in need of gastro-intestinal and hepato-biliary tract surgery, except 2 cases of Banti:s syndrome operated on Portal hypertension.
Among the entire series of 51 cases, only 15 cases were proved by biopsy to have normal liver tissue, as well as normal appearance of extrahepatic portal bed macroscopically. The average portal pressure in this normal group was 154±26mm. saline (baseline-anterior surface of the upper lumbar vertebral bodies.)
Among the intrahepatic disease group, 3 cases with severe liver cell degeneration due to severe shock and long term starvation, showed a low in portal pressure. In all other intrahepatic cases portal pressure was elevated.
In 7 cases with a slight to moderate degree of liver cirrhosis, the average portal pressure was
291mm. saline, which seems somewhat proportional to the degree of cirrhotic change.
5 Cases of liver cancer, all showed varying degrees of liver cirrhosis, and the portal pressures
were more elevated than in the cases with cirrhosis alone:
Also the cases of obstructive jaundice and hepatitis revealed slightly elevated portal pressures.
Among the histopathological findings in the livers, fibrosis, pseudolobular formation and round cell infiltration were intimately correlated with elevated portal pressure.
7 cases in the extrahepatic group showed moderately elevated portal pressures; most of them were compression or adhesion of extrahepatic portal bed due to severe malignant tumors in the abdomen.
Of 2 cases of Banti´s syndrome, one was found to have severe sclerosis of the splenic vessels with normal liver tissue; the portal pressure was lowered from 325mm. saline to 210mm. saline after splenectomy. The other cases had moderate cirrhosis of the liver with normal splenic vessels,. and the portal pressure was not altered by spleneotomy.
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