Portal hypertension and ascites in acute hepatitis: Clinical, hemodynamic and histological correlations

We attempted to ascertain the mechanism of portal hypertension and ascites complicating acute hepatitis in 66 patients who underwent transvenous liver biopsy and measurement of hepatic venous pressure gradient. Increase in hepatic venous pressure gradient was related to the severity of acute hepatitis, as indicated by the significant correlation between the values for hepatic venous pressure gradient and serum bilirubin, serum albumin or coagulation factor V, and by its higher value in patients with, than in patients without, encephalopathy. Hepatic venous pressure gradient was higher in patients with, than in patients without, ascites (12.5 ± 3.4 vs. 8.4 ± 3.6 mmHg, respectively; p < 0.001). No ascites was clinically detectable in the patients in whom hepatic venous pressure gradient was below 6 mmHg.

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