Portal Hypertension

Portal hypertension is a relatively common condition, the complications of which are frequently life threatening. Patients with portal hypertension represent an important por­ tion of the daily clinical work of abdominal radiologists, gastroenterologists and abdominal surgeons. During the past two decades the development of new radiological devices and of new percutaneous image-guided treatment methods has resulted in fundamental changes in the clinical management of patients with portal hypertension. During the same period tremen­ dous progress was achieved in the visualization of the numerous morphological and func­ tional changes observed in patients with portal hypertension, due to the clinical introduc­ tion of the new cross-sectional imaging methods: ultrasonography, computed tomography and magnetic resonance imaging. I am very grateful to Prof. Plinio Rossi, an internationally recognized leader in the field of interventional radiology, for accepting the challenging task of compiling and presenting in a structured way the numerous facts and data that have become available during the past few years in this rapidly developing field. The editor has been inspired and successful in his selection of the impressive group of international experts that has contributed to many chapters of this volume.

Portal hypertension has traditionally attracted great interest from physicians, surgeons, and radiologists owing to the accompanying high risk of gastrointestinal hemorrhage. Against this background the current volume, written by internationally recognized experts, sets out to provide a comprehensive coverage of the diagnosis and treatment of portal hypertension. An extensive description of the vascular anatomy of the portal system is given, and the pathophysiology and clinical characteristics of the disorder are reviewed. Both conventional and newer diagnostic techniques are then discussed and illustrated, particular attention being paid to techniques such as color Doppler and magnetic resonance that can simultaneously provide morphological and functional information. Medical, endoscopic, surgical, and radiological treatments are all considered, with special emphasis on the use of transjugular intrahepatic porto-systemic shunt (TIPS). Possible complications of treatment receive due attention, and avenues for future research are outlined. This volume will serve as an invaluable source of up-to-date information for all with an interest in the subject, and will provide a sound basis for therapeutic decision making.