Additional Supporting Information may be found in the online version of this article. “
“Severe portal hypertension is responsible for complications and death. Although measurement of the hepatic venous pressure gradient is the most accurate method for evaluating the presence and severity of portal hypertension, this technique is considered invasive and is not routinely performed in all centers. Several noninvasive techniques have been proposed to measure portal hypertension. Certain methods evaluate elements related to the pathogenesis of portal hypertension through the measurement of hyperkinetic syndrome, for example, or they investigate the development of hepatic

fibrosis through the measurement of increased intrahepatic vascular resistance. Other methods evaluate the clinical Metformin manufacturer consequences of portal hypertension, such as the presence of esophageal varices or the development of portosystemic shunts. Methods evaluating increased hepatic vascular resistance are fairly accurate and mainly involve the detection of hepatic fibrosis by serum markers and buy Natural Product Library transient elastography. The radiological assessment of hyperkinetic

syndrome probably has value but is still under investigation. The assessment of severe portal hypertension by the presence of varices may be performed with simple tools such as biological assays, computed tomography, and esophageal capsules. More sophisticated procedures seem promising but are still under development. Screening tools for large populations must be simple, whereas more complicated procedures could help in the follow-up of already diagnosed patients. Although most of these noninvasive methods effectively identify severe portal hypertension, methods for diagnosing moderate portal hypertension need to be developed; this shows that further investigation is needed in this field. (HEPATOLOGY 2011;53:683-694) Portal hypertension is one of the main causes of severe

complications and death in patients with cirrhosis. Thus, recommendations suggest that the presence and degree of portal hypertension be evaluated in all patients with cirrhosis and other chronic liver diseases.1 The degree of portal hypertension can be correlated with the severity of cirrhosis, which is estimated by either the selleck chemicals llc Child-Pugh score2 or histological lesions.3-5 As a result, an improvement in liver function is associated with decreases in portal hypertension6 and its complications. However, although a reduction in the degree of portal hypertension results in a decrease in the risk of complications, there is no improvement in liver tests. Portal hypertension is defined as an increase in the pressure in the portal vein and its territory. In normal, fasted subjects at rest and in the supine position, the portal pressure ranges from 7 to 12 mm Hg.

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