查看文章

The management of portal hypertension should be based on an updated knowledge of its natural history. Portal hypertension is an almost unavoidable complication of cirrhosis, and it is responsible for the more lethal complications of this syndrome: gastro-esophageal varices and massive gastrointestinal bleeding, ascites, hepatorenal syndrome, and hepatic encephalopathy. Appearance of these complications represents the major cause of death and liver transplantation in patients with cirrhosis. The prevalence of esophageal varices is very high: when cirrhosis is diagnosed, varices are present in about 40% of compensated patients and in 60% of those with ascites [1, 2]. After initial diagnosis of cirrhosis, the expected incidence of newly developed varices is about 5% per year [3]. Once developed, varices increase in size from small to large at an overall rate of 10–15% per year [3]. Progression of liver failure …