Evaluation of patients with portal hypertension.

In order to select the most suitable management of portal hypertension, a full evaluation of the patient is desirable. The aspects studied should include the possible causes of portal hypertension and the disease and function of the liver, as well as the psychosocial aspects of this condition. The usual reason to investigate the presence and causes of portal hypertension is the detection of gastroesophageal varices. The estimated probability of bleeding from the varices and the cause of the varices should be investigated. If cirrhosis is detected, then its cause or mechanism should be clarified and the activity of the process estimated in semiquantitative terms. If therapy is available, it should be initiated. The evaluation of liver function is based on quantitative measurements of hepatocellular metabolic function (such as the galactose elimination capacity or antipyrine clearance), liver volume (weight), liver blood flow, and systemic hemodynamics (cardiac output index).