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Although the past several years have seen tremendous progress in both the understanding and clinical management of portal hypertension-a major complication of cirrhosis-many new therapies and pathogenic principles are now emerging that will lead to vastly improved therapeutic approaches in the years to come. In Portal Hypertension: Pathobiology, Evaluation, and Treatment, internationally renowned investigators and clinicians discuss the latest findings on key scientific topics and review the evaluation and management of portal hypertension in the clinic. Writing in an easy-to-read style, the authors review its pathobiology, the progress being made in its experimental understanding, the methodologies to assess it in humans, the treatment of its complications (esophageal varices, ascites, and hepatorenal syndrome), and its treatment in special circumstances (during pregnancy, in children, or when the portal vein is blocked). They also provide in-depth coverage of the pros and cons of the various therapeutic choices available to the clinician managing patients with complicated portal hypertension.
State-of-the-art and readily accessible, Portal Hypertension: Pathobiology, Evaluation, and Treatment provides both an authoritative reference for all gastroenterologists and an indispensable resource for all physicians treating liver disease, particularly in a tertiary care setting.

Portal Hypertension: Pathobiology, Evaluation, and Treatment

Part I. Historical Perspective

Portal Hypertension: A History
Adrian Reuben and Roberto J. Groszmann

Part II. Pathobiology and Experimental Progress in Portal Hypertension

Anatomy and Vascular Biology of the Cells in the Portal Circulation
Massimo Pinzani and Francesco Vizzutti

Cell and Molecular Mechanisms of Increased Intrahepatic Resistance and Hemodynamic Correlates
Don C. Rockey

Molecular Mechanisms of Systemic Vasodilation and Hyperdynamic Circulatory State of Cirrhosis
Richard Moreau and Didier Lebrec

Mechanisms of Sodium Retention, Ascites Formation, and Renal Dysfunction in Cirrhosis
Andrés Cárdenas and Pere Gines

Hepatic Hemodynamics in Portal Hypertension: Compliance, Hepatic Arterial Buffer Response, Hepatorenal Syndrome, and Liver Regeneration
W. Wayne Lautt and Zhi Ming

Neovascularization, Angiogenesis, and Vascular Remodeling in Portal Hypertension
Manuel Morales-Ruiz and Wladimiro Jiménez

Mechanisms of Cardiopulmonary Hemodynamics and Dysfunction in Portal Hypertension
Michael B. Fallon

Part III: Methodology to Assess Portal Hypertension in Humans

Measurement of Hepatic Venous Pressure Gradient: Methods, Interpretation, and Pitfalls
G. Pomier-Layrargues and P. Michel Huet

Evaluation of Portal Hemodynamics Using Indicator Dilution and Noninvasive Techniques
Juerg Reichen

Endoscopic Assessment of Portal Hypertension Including Variceal Pressure Measurements: Methods, Interpretation, and Pitfalls
Angels Escorsell and Jaime Bosch

Part IV: Natural History and Treatment of Esophageal Varices

Clinical Features and Natural History of Variceal Hemorrhage: Implications for Surveillance and Screening
Juan G. Abraldes and Jaime Bosch

Management Strategies for the Prophylaxis and Treatment of Esophageal Variceal Rupture: AnOverview
Roberto de Franchis

Pharmacologic Therapy for the Management of Esophageal Varices: Biology and Utility of Available Agents
Norman D. Grace and Richard S. Tilson

Endoscopic Treatment for Bleeding Esophageal Varices
John P. Cello

Surgical Therapies for Management: Surgical Shunts and Liver Transplantation
J. Michael Henderson

Transjugular Intrahepatic Portosystemic Stent-Shunt: Technical Considerations and Clinical Utility in the Management of Variceal Hemorrhage
Dhiraj Tripathi, Peter C. Hayes, Doris N. Redhead, and Rajiv Jalan

Clinical Features and Management of Gastric Varices, Portal Hypertensive Gastropathy, and Ectopic Varices
Charmaine A. Stewart and Patrick S. Kamath

Part V: Natural History and Treatment of Ascites and Hepatorenal Syndrome

Ascites: Clinical Features, Diagnosis, and Natural History
Sakib Karim Khalid and Guadalupe Garcia-Tsao

Management of Ascites
Florence Wong

Spontaneous Bacterial Peritonitis and Other Infections in Cirrhosis
Rosa Maria Morillas and Ramon Planas

Diagnosis and Management of the Hepatorenal Syndrome
Kevin Moore

Part V: Evaluation and Treatment in Special Circumstances of Portal Hypertension

Pregnancy and Portal Hypertension
Bimaljit Sandhu and Arun J. Sanyal

Causes and Management of Portal Hypertension in the Pediatric Population
Frederick C. Ryckman, Maria H. Alonso, and Greg Tiao

Noncirrhotic Portal Hypertension and Portal Vein Thrombosis
Shiv K. Sarin and Manav Wadhawan

Hepatic Venous Outflow Obstruction: Budd-Chiari Syndrome and Veno-Occlusive Disease (Sinusoidal Obstruction Syndrome)
Hugo E. Vargas and Thomas D. Boyer

Pulmonary Complications Associated with Portal Hypertension
Karen L. Swanson and Michael J. Krowka

Health Status Assessment and Economic An