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AMA Arch Surg. 1950;61(4):713-731. doi:10.1001/archsurg.1950.01250020719012.
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THE PROBLEM of portal hypertension has received a great deal of attention during the past few years, and its pathologic physiology has been greatly clarified by the studies of Whipple and others.1 The hypertension within the portal system may be due to either intrahepatic or extrahepatic obstruction. The intrahepatic obstruction is most commonly due to cirrhosis of the liver and is characterized by ascites and esophageal varices, in addition to evidence of hepatic dysfunction. Extrahepatic obstruction is generally associated with the syndrome commonly termed Banti's disease, characterized by splenomegaly, anemia, leukopenia and, usually, esophageal varices. The obstruction in the portal system may be in the portal vein itself or in some portion of the splenic vein.1c It is usually possible to determine the site of the obstruction by measuring the differential pressures in the splenic, coronary and portal veins, but the cause of the obstruction is more difficult to establish.2


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