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Non-Cirrhotic Portal Hypertension: an Overview

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Abstract

Purpose of Review

Non-cirrhotic portal hypertension (NCPH) is a broad term, which includes a heterogeneous group of disorders characterized by elevated portal pressure in the absence of cirrhosis. Despite a better understanding, the diagnosis and treatment remains challenging. This review gives new insights into some of the recent advances.

Recent Findings

Although current guidelines for varices screening/surveillance are inadequate for NCPH, discovery of new genetic mutations helps us better understand its pathogenesis. Endohepatology is a promising emerging technique for an accurate diagnosis of NCPH. Pregnancy is not contraindicated however; multidisciplinary team approach is needed for an optimal outcome.

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Authors and Affiliations

  1. The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Sajid Jalil

  2. Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville School of Medicine, Transplant Hepatologist, Trager Transplant Center at Jewish Hospital, Louisville, USA

    Ashwani K. Singal

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  1. Sajid Jalil
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SJ wrote the initial draft of the manuscript. AKS supervised and reviewed the first draft to make edits. All the authors reviewed and approved the manuscript.

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Correspondence to Ashwani K. Singal.

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Take Away Points

A good liver imaging should be performed to diagnose extrahepatic portal or splenic vein thrombosis as a cause for portal hypertension.

A liver biopsy is critical in the diagnosis of NCPH and excludes cirrhosis as cause of portal hypertension.

A comprehensive clinical evaluation is important for etiological diagnosis. Immunological and thrombophilia screen should be performed for patients without an obvious cause.

Endohepatology with endoscopic ultrasound-guided liver biopsy with simultaneous measurement of portal pressure gradient is an emerging technique to expedite the diagnostic process.

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Jalil, S., Singal, A.K. Non-Cirrhotic Portal Hypertension: an Overview. Curr Hepatology Rep 23, 153–161 (2024). https://doi.org/10.1007/s11901-024-00642-x

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