Idiopathic portal hypertension complicated by ischemic hepatitis: the diagnostic importance of hemodynamics and liver biopsy.

The etiology of idiopathic portal hypertension (IPH) is unknown. IPH is characterized by periportal fibrosis, portal hypertension, the formation of esophageal varices, and the development of portosystemic collateral vessels, splenomegaly, and secondary hypersplenism, all of which appear in the absence of hepatic cirrhosis (1). However, there are clinical situations that can coexist with IPH that render its diagnosis difficult, as we experienced in a patient in whom the presentation was complicated by ischemic hepatitis and abnormal liver enzymes. In most cases, liver biopsy and portal pressure measurements are sufficient to make the correct diagnosis.