Liver & intrahepatic bile ducts
Vascular disorders
Portal hypertension

Topic Completed: 1 January 2018

Revised: 24 January 2019, last major update January 2018

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Portal hypertension[TI] liver[TI] free full text[sb]pathology

Raul S. Gonzalez, M.D.
Page views in 2019: 1,072
Page views in 2020 to date: 1,019
Cite this page: Gonzalez R. Portal hypertension. website. Accessed September 21st, 2020.
Definition / general
  • Increased blood pressure within portal venous system
Essential features
  • Causes are numerous and can be divided into prehepatic, intrahepatic and post hepatic
  • Cirrhosis is most common cause
  • Patients without cirrhosis typically are labeled with "noncirrhotic portal hypertension"
Clinical features
  • Clinical complications include ascites, portosystemic venous shunts (hemorrhoidal veins, esophageal varices, etc.), congestive splenomegaly, hepatic encephalopathy
  • Gold standard is measurement of hepatic venous pressure gradient via portal vein catheterization
  • Ultrasound is noninvasive and can detect signs of portal hypertension
Microscopic (histologic) description
Microscopic (histologic) images

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Idiopathic non-cirrhotic portal hypertension

Board review style question #1
    A patient is found to have portal hypertension in the absence of cirrhosis. Considering the most common overall cause of noncirrhotic portal hypertension, which of the following is most likely to be seen on liver biopsy?

  1. Herniated portal veins
  2. Mastocytosis
  3. Nodular hepatocyte parenchyma
  4. Parasite eggs
  5. Sinusoidal fibrosis
Board review answer #1
D. Parasite eggs: Schistosomiasis is the most common cause of noncirrhotic portal hypertension in the world
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