Portal Hypertension and Primary Biliary Cirrhosis

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Abstract
Portal hypertension was regarded as an uncommon and late complication of primary biliary cirrhosis (PBC). Patients (24) with PBC were investigated for portal hypertension. Esophageal varices were present in 20, 50 and 90% of the patients 1, 3 and 9 yr, respectively, after the onset of pruritis and/or jaundice. Portal hypertension was responsible for gastrointestinal bleedings in 11 patients; bleeding was the 1st clinical manifestation of PBC in 2 of them. Wedged hepatic venous pressure was increased in all the patients with portal hypertension whether regenerative nodules were present or absent. Portacaval shunt was performed in 5 patients and was well tolerated in 3 of them. Portal hypertension is common in PBC; the intrahepatic block is of the so-called postsinusoidal type, even in patients without regenerative nodules. Gastrointestinal bleeding due to portal hypertension occurs in about half of the patients and may be the 1st manifestation of PBC. A portacaval shunt seems to be indicated when gastrointestinal bleeding occurs in earlier stage of the disease.