Extrahepatic portal hypertension

Abstract

Extrahepatic portal venous obstruction is an important cause of non-cirrhotic portal hypertension, especially in third world countries. Material and methods. Contemporary literature analysis focused on the main databases: PubMed, Hinari, SpringerLink and Scopus (Elsevier) was performed. Inclusion criteria served clinical practice guidelines, scientific articles on current knowledge addressed: causes, diagnostic criteria and differential diagnosis of extrahepatic portal venous obstruction. Exclusion criteria were articles that did not meet the current requirements and information provided for patients. Results. The term non-cirrhotic portal hypertension refers to a heterogeneous group of liver diseases affecting the hepatic vasculature that are anatomically classified based on blood flow resistance as pre-hepatic, hepatic (pre-sinusoidal, sinusoidal or post-sinusoidal) and post-hepatic in the absence of liver cirrhosis or known risk factors responsible for portal hipertension. Multiple hematological, immune system-related, infectious, hereditary and metabolic risk factors have been associated with this disorder. However, the exact etiopathogenesis is largely unknown. Conclusions. The diagnosis of this pathology requires a multidisciplinary approach, through evaluation by a gastroenterologist, hematologist, cardiologist, and requires an increase in the degree of awareness of this entity by highlighting the complex pathophysiology and clinical-pathological associations.