Portographic findings and coagulopathy in cirrhosis.

Percutaneous transhepatic portography was performed in 57 patients with cirrhosis and portal hypertension. The portographic findings, the free portal pressure and the coagulation tests were analyzed. Moderate or severe abnormality of the coagulation system was significantly associated with extrahepatic shunting, large gastric varices and collaterals from the splenic vein and splenic hilum. Reduced levels of prothrombin, factor X and thrombocyte counts were the factors mainly accounting for this association. As severe variceal bleeding is associated with these changes in the portal circulation, identification of patients at high risk may be based on portography combined with examination of the coagulation system.