Intrahepatic portal vein sclerosis in patients without a history of liver disease. An autopsy study.

Portal fibrosis with portal venous obliteration is characteristic of noncirrhotic portal hypertension, but similar lesions are also commonly seen in patients without clinical evidence of liver disease. Thus, the ability to predict the presence of portal hypertension with histologic criteria will probably depend on a quantitative assessment of liver tissue. The purpose of this study is to provide a quantitative basis in a "normal" population for evaluation of portal vein obliteration. We reviewed 414 consecutive autopsies of patients without known history of alcoholism or clinical liver disease. Intrahepatic portal vein obliteration was graded 0 to III. The grading system was standardized by morphometry on 34 selected cases. The incidence of portal vein lesions increased with age and reached a plateau at about 60 years of age. Lesions were more common in patients who had severe congestive heart failure or arterial thrombosis. These associations suggest that obliterative lesions may be the result of thrombosis in patients with sluggish portal blood flow or hypercoagulability. Portal tract mineral oil deposits may also have a role, because they were found more often than expected in livers with portal sclerosis.