Portographic liver changes in idiopathic noncirrhotic portal hypertension.

Intraoperative and transhepatic portograms in patients with noncirrhotic portal hypertension, or idiopathic portal hypertension, were compared with portograms of patients with liver cirrhosis. Although the portograms in idiopathic portal hypertension varied from case to case, they were distinctly different from those in cirrhosis. The most common features of the former included a paucity of medium-sized portal branches, irregular and often obtuse-angled division of the peripheral branches, occasional abrupt interruptions of them, an avascular area beneath the liver surface, nonopacification of some of the large intrahepatic portal branches and of their periphery, and increase of very fine vasculature around large intrahepatic portal branches. These findings are compatible with occlusion of intrahepatic portal vessels at various levels.