Korean J Pathol.  2006 Oct;40(5):348-353.

Clinicopathological Analysis of Eight Cases of Idiopathic Portal Hypertension

Affiliations
  • 1Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. esyu@amc.seoul.kr
  • 2Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 3Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Abstract

BACKGROUND: Idiopathic portal hypertension (IPH) is a rare clinicopathologic entity that shows clinical evidences of portal hypertension with no pathologic features of cirrhosis.
METHODS
The clinical and pathologic features of 8 cases with IPH were analyzed via the medical records along with the biopsy or resected liver specimens.
RESULTS
Six patients were male and two were female. The chief complaints were sudden variceal bleeding in seven patients and abdominal pain in one patient. Six patients were treated with varix ligation and one was treated with splenectomy after the failure of bleeding control. One patient underwent a liver transplantation due to severe symptoms of portal hypertension. The prognosis of all the patients was excellent. Microscopically, the portal tracts were variably fibrotic, and the portal veins in them were sclerotic, obliterated or dilated in 7 cases; pathologic abnormalities were absent in 1 case. Cirrhosis was absent in all cases, while septal fibrosis was present in one resected liver.
CONCLUSIONS
IPH is a minor cause of portal hypertension. However, a liver biopsy to show the subtle portal vascular changes and fibrosis in patients who have the clinical symptoms of portal hypertension is important for making the diagnosis of IPH.

Keyword

Idiopathic portal hypertension; Liver; Biopsy; Noncirrhotic portal hypertension

MeSH Terms

Abdominal Pain
Biopsy
Diagnosis
Esophageal and Gastric Varices
Female
Fibrosis
Hemorrhage
Humans
Hypertension, Portal*
Ligation
Liver
Liver Transplantation
Male
Medical Records
Portal Vein
Prognosis
Splenectomy
Varicose Veins
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