I WILL present a personal approach to the problem of portal hypertension, without attempting to cover the subject exhaustively, but emphasizing what I feel to be the important points for consideration in relation to the management of patients. Causes of portal hypertension The most important cause of portal hyperten-sion is chronic liver disease which usually implies cirrhosis of the liver. The...

Spontaneous bacterial peritonitis is defined by a positive ascitic fluid bacterial culture and an elevated ascitic fluid absolute polymorphonuclear count (≥250 cells/mm3) without an evident intra-abdominal, surgically treatable source of infection. Transient ascites is well documented in patients with extrahepatic portal venous obstruction but spontaneous bacterial peritonitis complicating extr...

Intrahepatic venous collaterals develop in Budd-Chiari syndrome, hepatomas, and other tumors if the hepatic veins are obstructed. In portal hypertension hepatic vein-to-vein anastomoses develop without obstruction of the hepatic veins. In a 53-year-old woman with giant cavernous hemangioma of the liver, hepatic venography demonstrated remarkable hepatic vein-to-vein anastomoses in the periphery...

Budd-Chiari syndrome is defined as hepatic venous outflow tract obstruction regardless of the level of the obstruction (anywhere between the small hepatic veins to the junction of the inferior vena cava and right atrium) or the cause of obstruction. It is frequently associated with hepatomegaly, abdominal pain, ascites and hepatic dysfunction, and patients with Budd-Chiari syndrome often demons...

The unique dual blood supply of the liver (75% portal venous, 25% hepatic arterial) makes multiphase helical computed tomography (CT) a highly suitable technique for hepatic evaluation with imaging in two (arterial and portal venous) or more phases. Multiphase helical CT has become an important tool in the detection and characterization of hepatic tumors. In some situations, hemodynamic changes...

Budd-Chiari syndrome (BCS) is a rare condition which occurs when there is obstruction of the hepatic veins. It includes any condition in which there is obstruction to venous flow from the small hepatic veins to the inferior vena cava. It should be differentiated from veno-occlusive disease in which the sinusoidal epithelial cells of the hepatic venules are damaged; this mainly occurs after stem...

Budd-Chiari syndrome (BCS) is a rare condition which occurs when there is obstruction of the hepatic veins. It includes any condition in which there is obstruction to venous flow from the small hepatic veins to the inferior vena cava. It should be differentiated from veno-occlusive disease in which the sinusoidal epithelial cells of the hepatic venules are damaged; this mainly occurs after stem...

Hepatic venous outflow obstruction following liver transplantation is rare but disastrous. Here we described a 14-year-old boy who underwent a split right lobe liver transplantation with modified (side-to-side) piggyback technique which resulted in hepatic venous outflow obstruction. When the liver graft was lifted up, the outflow drainage returned to normal but when it was placed back into the...

We describe a patient with extrahepatic portal venous obstruction due to a giant hepatic hemangioma associated with Kasabach-Merritt syndrome. A 67-year-old woman presented with upper abdominal distension and appetite loss. The medical history was not relevant to the current disorder. Initial laboratory tests revealed the following: serum platelet count, 9.9 × 10⁴/µL; serum fibrinogen degradati...