A CASE OF IDIOPATHIC PORTAL HYPERTENSION: THE PROGRESSION OF THE HEPATIC FEATURES DEMONSTRATEDBY LAPAROSCOPY AND COMPUTED TOMOGRAPHY

Abstract

A 38-year-old woman was admitted for the therapy of esophageal varices in June 1989. Laparoscopic examination demonstrated the mild undulation of the liver surface. No evidence of viral hepatitis or liver cirrhosis was observed. Histological examination of the liver biopsy specimen demonstrated the findings consistent with idiopathic portal hypertension without hepatitis and cirrhosis of the liver. Endoscopic injection sclerotherapy was performed for the therapy of the varices. In October 1992 recurrence of esophageal varices was observed and she was admitted again. Computed tomography revealed the atrophy of right hepatic lobe and the hypertrophy of left hepatic lobe with marked splenomegaly. Laparoscopic examination showed remarkable undulation of the liver surface and regenerative nodule formation. In idiopathic portal hypertension the development of the morphological changes of the liver is rarely reported. This is a significant case in whom the changes of the liver lesions were clearly demonstrated by computed tomography and laparoscopy.