Scandinavian journal of gastroenterology
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Scand. J. Gastroenterol. · Aug 2002
Intrahepatic heterogeneity of hepatic venous pressure gradient in human cirrhosis.
The hepatic venous pressure gradient (HVPG) is used to evaluate portal hypertension. ⋯ Our results demonstrate a hitherto unrecognized notable heterogeneity of the intrahepatic vasculature and HVPG measurements in cirrhosis. The presumption of interposition of non-flowing blood between the catheter tip and the portal system for the measurement of HVPG may thus be violated in about one-third of the cirrhosis cases because of abnormal outlet into hepatic venous shunts and in a minor fraction because of abnormal arterial inlet. In 26%, one measurement was below 12 mmHg, the other measurement above. If the HVPG had been measured in only one liver vein, 13% of the cases would have been classified in a lower risk group than appropriate according to the 12 mmHg concept of risk of bleeding from oesophageal varices.