Chinese Medical Journal

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PORTAL HYPERTENSION A38

Table 9. Hippuric acid test

Abnormal Not f Amount of _No. 0 excretion Normal 3 9-33 gm (oral) Below 3.0 gm Percent- Ca cases 0.5-0.7 gm (I.V.) Below 0.5 gm age nnn EnEEEEEE EEE Intrahepatic 38 12 3 28.3 1 54 Extrahepatic 6 1 : 0 14.3 2 9 a Total 44 13 - 3 26.7 3 63

LL

the intrahepatic and extrahepatic type of cases was distinctly shown. Impairment of liver function was more marked and more frequent in the intrahepatic group, and there was not a single case in the extrahepatic group that showed marked impairment of liver function. Hence it may be stated that if slight impairment of liver function is present, the case may be either an intrahepatic portal bed block or an extrahepatic one; but when marked impairment is present, it points to the diagnosis of intrahepatic type of portal obstruction. —

6. Urobilinurea. Test for urobilin in the urine was carried out in 52 cases. It was positive in 16 cases with intrahepatic obstruction, or 36.4 per cent, and in only 1 case with extrahepatic obstruction, or 12.5 per cent (Table 10). The finding of urobilin in the urine favors the diagnosis of intrahepatic portal bed block.

Table 10. Presence of urobilin in urine

Positive Not

Urobilin Negative —————___________ No.of No.ofcases Percentage recorded Cases Intrahepatic 28 16 36.4 10 54 Extrahepatic 7 1 12.5 1 9 Total 35 17 Bae 11 63

7. Esophageal varices. Barium meal examination of the esophagus was done in 61 cases. Definite varices were found in 37 cases, doubtful in 1 and negative in 23. The incidence of esophageal varices was 61.7 per cent.’ Correlation of the incidence of esophageal varices with that of hermatemesis in the two groups showed (Table 11):

Table 11. The relationship between esophageal varices and hematemesis

Esophageal With positive With negative Total varices roentgenologic findings roentgenologic findings Type of z Cases with . Cases with No. of Cases with obstruction —_ No. of cases yematemesis No. of cases hematemesis cases hematemesis Intrahepatic 30 (58.8%) 10 (33.3%) 21 (41.2%) 4 (19.0%) 51 14 (27.5%) Extrahepatic 7 (17.8%) 3 (42.9%) 2 (22.2%) 0 9 3 (33.3%)

Total 37 (61.7%) 13 (35.1%) 23 (38.3%) 4 (17.4%) 60 17 (28.3%)