Diagnosing portal hypertension

It is important to diagnose portal hypertension owing to its devastating complications. Clinicians need to be able to recognize physical signs and symptoms associated with portal hypertensive states. When in doubt, appropriate diagnostic measures need to be performed and a definite diagnosis made. Hepatic venous pressure gradient (HVPG) is often used as a surrogate measurement of portal pressure. HVPG can be obtained safely and conveniently on an outpatient basis. It can also be used to assess efficacy of various treatment modalities. Knowledge of pathophysiology of portal hypertension has provided the basis for further trials in both novel treatment modalities and diagnostic methods.