Lebrec D, Benhamou J P
Semin Liver Dis. 1986 Nov;6(4):332-40. doi: 10.1055/s-2008-1040615.
Portal hypertension, widely recognized as a complication of cirrhosis, may also develop as an intrahepatic consequence of numerous hepatic disorders in the absence of cirrhosis. When gastrointestinal bleeding occurs in such cases, ruptured esophageal varices must be considered. Among chronic liver diseases, some, such as schistosomiasis, are commonly associated with portal hypertension and its complications. In others, including tuberculosis, amyloidosis, and polycystic disease, well-documented portal hypertension has been reported in only a small minority of cases. Nevertheless, because of the ever-present possibility of variceal hemorrhage whenever portal hypertension occurs, clinicians should be aware of these disorders. Acute conditions associated with noncirrhotic intrahepatic portal hypertension include acute (and particularly fulminant) viral or drug-induced hepatitis, acute alcoholic hepatitis, acute veno-occlusive disease, and acute fatty liver of pregnancy. Portal hypertension may be reversible following recovery in these settings. Particular attention is called to the increasing frequency of acute veno-occlusive disease on bone marrow transplant units, presumably as a complication of high-dose chemo- and radiotherapy.
门静脉高压症，作为肝硬化的一种并发症广为人知，在无肝硬化的情况下，也可能作为多种肝脏疾病的肝内后果而发生。当此类病例出现胃肠道出血时，必须考虑食管静脉曲张破裂。在慢性肝病中，一些疾病，如血吸虫病，通常与门静脉高压症及其并发症相关。而在其他疾病中，包括结核病、淀粉样变性病和多囊肾病，仅有少数病例报告有确切记录的门静脉高压症。然而，由于门静脉高压症一旦发生就始终存在静脉曲张出血的可能性，临床医生应了解这些疾病。与非肝硬化性肝内门静脉高压症相关的急性病症包括急性（尤其是暴发性）病毒或药物性肝炎、急性酒精性肝炎、急性肝静脉闭塞病和妊娠期急性脂肪肝。在这些情况下，门静脉高压症在恢复后可能是可逆的。特别需要注意的是，骨髓移植病房中急性肝静脉闭塞病的发病率不断上升，这可能是高剂量化疗和放疗的一种并发症。
