Idiopathic portal hypertension misdiagnosed as hepatitis B cirrhosis: A case report and review of the literature.

IF 2.5 Q2 GASTROENTEROLOGY & HEPATOLOGY
Xiao-Chen Liu, Hui-Hui Yan, Wei Wei, Qin Du
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Abstract

Background: Idiopathic portal hypertension (IPH) is a subtype of portal hypertension that arises in the absence of cirrhosis. IPH frequently manifests with clinical features typical of portal hypertension, including splenomegaly and esophagogastric fundal varices, along with other associated symptoms. Imaging studies may indicate portal hypertension; however, they typically do not provide evidence of cirrhosis. There are no standardized diagnostic criteria for IPH, and diagnosis is often established by excluding other hepatic diseases. Liver biopsy remains the most reliable approach to verify the diagnosis of IPH.

Case summary: A patient previously diagnosed with "hepatitis B cirrhosis" at an external hospital presented to our facility with gastrointestinal bleeding. Initial assessment revealed minor liver injury, splenomegaly, esophagogastric varices, and portal hypertension. Imaging studies did not indicate cirrhosis and repeated hepatitis B serology tests yielded negative results. After excluding various causes of cirrhosis and other non-cirrhotic etiologies of portal hypertension, liver biopsy confirmed the diagnosis of IPH. The patient was managed with regular endoscopic therapy and long-term carvedilol administration.

Conclusion: Currently, there are no standardized diagnostic criteria for IPH, and its diagnosis is generally established by excluding other conditions. Liver biopsy remains the most reliable method for IPH diagnosis.

特发性门静脉高压误诊为乙型肝炎肝硬化1例报告及文献复习。
背景:特发性门静脉高压(IPH)是门静脉高压的一种亚型,在没有肝硬化的情况下发生。IPH常表现为门静脉高压的典型临床特征,包括脾肿大和食管胃底静脉曲张,并伴有其他相关症状。影像学检查可能提示门静脉高压症;然而,它们通常不能提供肝硬化的证据。IPH没有标准化的诊断标准,通常通过排除其他肝脏疾病来确定诊断。肝活检仍然是验证IPH诊断最可靠的方法。病例总结:一名曾在外院诊断为“乙型肝炎肝硬化”的患者因胃肠道出血来到我院。初步评估显示轻微肝损伤、脾肿大、食管胃静脉曲张和门脉高压。影像学检查未显示肝硬化,多次乙型肝炎血清学检查结果为阴性。在排除各种肝硬化和其他非肝硬化门静脉高压症的病因后,肝活检证实了IPH的诊断。患者接受常规内镜治疗和长期卡维地洛治疗。结论:目前IPH没有标准化的诊断标准,其诊断一般是排除其他条件后建立的。肝活检仍然是诊断IPH最可靠的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World Journal of Hepatology
World Journal of Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.10
自引率
4.20%
发文量
172
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