Radiological procedures in portal hypertension.

Radiological diagnosis in portal hypertension is of paramount importance for proper treatment. The site of portal obstruction is determined preoperatively by either direct (splenoportography, transumbilical portography, epiploography, selective percutaneous transhepatic catheterization) or direct (catheterization of the celiac truncus and/or the superior mesenteric artery) methods. After a shunt procedure the examination can best be done with a balloon catheter, by direct catheterization of a shunt or by indirect splenoportography. Recently, the radiologist has started to do the treatment by percutaneous transhepatic injection of a sclerosing agent into the gastric coronary vein. For each different method the advantages and disadvantages, the indications and technical procedure are described and discussed.