Portal hypertension is not a disease in the usual sense of the term. Rather, it is a secondary or tertiary hemodynamic manifestation of one or another of a variety of diseases. The problems associated with portal hypertension are as much those of the underlying diseases as they are of the high pressure in the portal circulation. In the United States, the primary disease is chronic alcoholism in the majority of cases of portal hypertension. It has been estimated that there are 8 million chronic alcoholics in this country. During the past two decades, the incidence of chronic alcoholism has increased dramatically, and it is clearly a major social, economic, and public health problem.
The secondary disease responsible for portal hypertension is some form of cirrhosis of the liver in over 90% of the cases. In the United States, most patients with portal hypertension have alcoholic liver disease. Cirrhosis is reported