CARROLL M. LEEVY, M.D., F.A.C.P.; MYRA ZINKE, M.D.; JULIUS BABER, M.D.; WOO YOON CHEY, M.D.
Choice of medical or surgical therapy for portal hypertension and its manifestations in cirrhosis has been the subject of considerable debate. Proponents for surgical therapy feel that portal hypertension is usually due to irreversible factors and requires operative intervention;1-3 others believe reversible morphologic and functional alterations contribute to an elevated portal pressure, and advise prolonged medical management.4-7
Improved technics for the study of hepatic circulation in man have provided greater objectivity in evaluating response to medical therapy. Portal pressure may be measured indirectly by wedged hepatic vein catheterization,7-14 percutaneous splenic puncture15, 16 and transesophageal manometric recordings.17 These studies, coupled with
LEEVY CM, ZINKE M, BABER J, CHEY WY. OBSERVATIONS ON THE INFLUENCE OF MEDICAL THERAPY ON PORTAL HYPERTENSION IN HEPATIC CIRRHOSIS12. Ann Intern Med. ;49:837–851. doi: 10.7326/0003-4819-49-4-837
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Published: Ann Intern Med. 1958;49(4):837-851.
Gastroenterology/Hepatology, Liver Disease.
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