Diagnosis and treatment of portal hypertension.

Major progress has been made in the area of diagnosis and treatment of portal hypertension. Multi-detector row computed tomography (MD-CT) enabled the revelation of the precise overview of portal hemodynamics and was applied into the decision of therapeutic strategies. A noninvasive liver stiffness measurement device, transient elastography, is expected to be applied in the prediction of existence of esophageal varices. Balloon-occluded retrograde transvenous obliteration (B-RTO) is performed mainly in Japan to eradiate the fundic varices and high eradiation rate and low recurrence rate are reported. Partial splenic embolization (PSE) has been performed to improve hypersplenism without serious side-effect and excellent result is reported. Angiotensin receptor blockers (ARBs) are promising drugs for its portal hypotensive effect and antifibrotic effect and more investigation is necessary. Anti-fibrotic therapy, including autologous bone marrow therapy, has the possibility to improve not only liver fibrosis but also portal hypertension.