Chinese Medical Journal

2 es

Chinese Medical Journal, 74: 37-53, January-February, 1956.

PORTAL HYPERTENSION A CLINICAL STUDY OF SIXTY-FIVE CASES

HUANG Ts’UI-T'ING (@## ), CHANG CHIA-CH’ING (R232) AND YANG YL-HSsIN (#2213) Department of Surgery, Central People’s Hospital, Peking

Portal hypertension, as now generally recognized, is a clinical syndrome caused by intrahepatic or extrahepatic obstruction of the portal system with manifestations of splenomegaly, pancytopenia, and tendency to ascites and repeated gastrointestinal hemorrhage, often accompanied by cirrhosis of the liver. The disease is not infrequently seen in China.

From March 1950 to. February 1954, 78 patients with portal hypertension were admitted to the Central People’s Hospital and 65 of them received various types of operative treatment. A clinical study of the 65 cases is presented in this paper, special emphasis being placed in comparing the differences between the intrahepatic and extrahepatic types of portal obstruction in regard to their symptoms, clinical findings and results of treatment.

ETIOLOGY

Any obstruction to the portal blood flow will cause portal hypertension. In our series of 65 cases the abdomen was explored and the diagnosis was confirmed by pathological section in 63 patients; in the remaining 2, mediastinotomy was done and the location of the obstruction was not ascertained. The obstruction was intrahepatic in 54 cases, or 69.7 per cent, and extrahepatic in 9 cases, or 14.3 per cent. In the extrahepatic group, the liver was found to be grossly and microscopically normal in all the cases but the exact site and cause of obstruction were not determined (Table 1). In a report by Lan and others(1) on 41 cases of portal hypertension seen in south China, the cause of obstruction in 80.5 per cent was schistosomiasis of the liver. In our group of patients, mainly inhabitants of north China, the cause of obstruction in 79.4 per cent of them was Laennec’s cirrhosis of liver. These figures indicate that the pathogenesis of the condition in the two regions is quite different.