A 43-year-old man with chronic hepatitis and liver cirrhosis is admitted with upper GI bleeding. He has marked ascites and shows multiple telangiectasias, liver palmar erythema, and clubbing. A diagnosis of bleeding esophageal varices secondary to portal hypertension is made. Portal pressure is considered elevated when it is above which of the following?: (A) 0.15 mm Hg, (B) 1.5 mm Hg, (C) 12 mm Hg, (D) 40 mm Hg
Answer is C. Portal hypertension is suspected clinically if esophageal varices are detected, hypersplenism occurs, or ascites develop. Normal portal venous pressure is 5-10 mm Hg. Pressure may be measured indirectly by using hepatic venous wedge pressure (occlusive hepatic wedge pressure). About two-thirds of patients with portal hypertension will develop varices of which one-third will bleed.