[Portal hypertension in chronic hepatitis (author's transl)].

Portal hypertension as the basis of threatening complications determines the subsequent fate of many patients with chronic inflammatory diseases of the liver. Normal values are exceeded considerably already in chronic hepatitis, but critical levels of pressure--with respect to the danger of bleeding from oesophageal varices--are only attained when cirrhotic remodelling is complete. With the aid of laparoscopic transhepatic manometry (LTM), we measured the levels of pressure in the branches of the portal vein and the hepatic vein in 23 patients suffering from chronic hepatitis (CH). In patients with chronic persistent hepatitis (CPH), the pressure in the portal vein was 17,7, in the hepatic vein 12,3 mm Hg (n = 4). In a group of 15 patients presenting with chronic aggressive hepatitis (CAH) with marked remodelling extending to cirrhosis, the average pressures were 19,9 and 11,8 mm Hg respectively; in four patients with CAH and, as yet, only slight fibrosis, the corresponding figures were 18,8 and 11,0 mm Hg respectively. In view of the recorded incidence of bleeding in 42 patients with complete hepatic cirrhosis, the early detection and intensive treatment of CH is of particular importance.