Increased portal pressure during variceal bleeding may have an influence on the treatment failure rate, as well as on short‐ and long‐term survival. However, the usefulness of hepatic hemodynamic measurement during the acute episode has not been prospectively validated, and no information exists about the outcome of hemodynamically defined high‐risk patients treated with early portal decompression. Hepatic venous pressure gradient (HVPG) measurement was made within the first 24 hours after admission of 116 consecutive patients with cirrhosis with acute variceal bleeding treated with a single session of sclerotherapy injection during urgent endoscopy. Sixty‐four patients had an HVPG less than 20 mm Hg (low‐risk [LR] group), and 52 patients had an HVPG greater than or equal to 20 mm Hg (high‐risk [HR] group).

HR patients were randomly allocated into those receiving transjugular intrahepatic portosystemic shunt (TIPS; HR‐TIPS group, n = 26) within the first 24 hours after admission and those not receiving TIPS (HR‐non‐TIPS group). The HR‐non‐TIPS group had more treatment failures (50% vs. 12%, P =.0001), transfusional requirements (3.7 ± 2.7 vs. 2.2 ± 2.3, P =.002), need for intensive care (16% vs.

Buffalo linkstation install optware packages. Portal hypertension occurs in a number of disorders other than cirrhosis and they are collectively called non-cirrhotic portal hypertension (NCPH). Hipertensi portal harus difikirkan bila pada anak terjadi perdarahan saluran cerna, terutama jika di dukung data splenomegali. Pemeriksaan fisik harus diarahkan untuk melihat tanda-tanda penyakit kronis yaitu gagal tumbuh, kelemahan otot, telengktasi dan caput meduse, ikterik, asites atau ensepalopati.