PARENCHYMATOUS DISEASE OF THE LIVER A CAUSE FOR RISE IN PORTAL BLOOD PRESSURE

Abstract

In attempting an explanation for ascites in hepatic cirrhosis, we must consider the blood pressure and minute volume of flow in the aorta and cava. If the pressure and flow of blood in the aorta and cava are unchanged, then obviously the only hydraulic considerations are those which may affect blood pressure within the portal vein. There is an abundance of evidence from pathologic sources to prove that ascites may be caused by stenosis of the portal trunk from pylephlebitis. In many instances of hepatic syphilis, ascites is due solely to this source. If the portal pressure is gradually raised during a long period of time, anastomoses form which may be sufficient to keep the portal pressure sufficiently low to prevent ascitic accumulations. But these factors alone are not sufficient to explain why some cirrhoses of the liver are attended with ascites and others are not, when the entire group