Portal hypertension historical perspective

Jump to navigation Jump to search

Portal Hypertension Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Portal Hypertension from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography and Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Portal hypertension historical perspective On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Portal hypertension historical perspective

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Portal hypertension historical perspective

CDC on Portal hypertension historical perspective

Portal hypertension historical perspective in the news

Blogs on Portal hypertension historical perspective

Directions to Hospitals Treating Portal hypertension

Risk calculators and risk factors for Portal hypertension historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

In 1511, Leonardo da Vinci, Italian Renaissance polymath, first describe the portal hypertension in an illustration in his textbook "De humanis corpore". “... the artery and the vein which go from the spleen to the liver become so large, to block the blood coming from the mesenteric vein; the latter vein dilates and becomes tortuous like a snake, that the liver dries and become like frozen bran, in colour and consistency…”, this presentation was inaccurately described as the cause of portal hypertension. In 1937, William Thompson, a Canadian biologist, measured the portal vein pressure for the first time. He did the measurements in the open abdomen for both inferior vena cava (IVS) and portal vein. In 1939, Crafoord and Fenckner, Dutch cardiac surgeons, used sclerosing agents (quinine solutions) to treat the esophageal varices via endoscopy. The procedure was rarely used because of high rates of re-bleeding. In 1980s, researchers have observed that endoscopic sclerotherapy is more efficient than surgical shunting in preventing recurrent variceal bleeding. In 1967, Thomas Earl Starzl, an American physician, mentioned that liver transplantation is the only way to treat both portal hypertension and the underlying hepatic disease.

Historical Perspective

Vesalius: Portal system in the “De Humani Corporis Fabrica”, Via Wikimedia.org[1]
First illustration of portal vascular system - By Francis Glisson, via Wikimedia Commons[2]
First illustration of cirrhosis - By René-Théophile-Hyacinthe Laennec [Public domain], via Wikimedia Commons[3]
 
 
 
First explanation of the portal venous system in human body
Herophilos, a Greek physician
IV century B.C.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First presentation of liver vascular system anatomy
Mondino de Liuzzi (Mundinus), an Italian surgeon
1319
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First description of portal hypertension
Leonardo da Vinci, Italian Renaissance polymath
1511
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First description of portal system accurately
Andreas van Wesel (Andrea Vesalio in Latin), Flemish anatomist
1543
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First demonstration of the portal circulation
Francis Glisson, a British physician
1650
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First description of the characteristics of cirrhotic liver
Giovani Battista Morgagni, an Italian anatomist
1761
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First coined the name cirrhosis, from antique Greek words of "Skirros" (hard, fibrotic) and "Kirrhos" (yellowish)
Renè Laennec, a French physician
1819
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First introduction of the term "portal hypertension"
Augustin Gilbert, a French physician
1902
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First showing splenomegaly as the result of portal hypertension
Archibald McIndoe, a New Zealand plastic surgeon
1928
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First measured the portal vein pressure
William Thompson, a Canadian biologist
1937
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
First used percutaneous measurement of intrasplenic pressure for diagnosis of portal hypertension
Lebon, an Algerian physician
1950
 
 
 

Discovery

  • Herophilos, a Greek physician, was the first scientist to explain the portal venous system in human body in the 4th century B.C. “…nature made special veins which are dedicated to the nourishment of the intestine and they do not pass to the liver; these veins end in glandular bodies, while all the other veins are carried back to the portae...”, he mentioned.[4]
  • In 1319, Mondino de Liuzzi (Mundinus), an Italian surgeon, published the textbook named "Anhotomia" and described the anatomy of liver vascular system for the first time. The book was the most reliable textbook of anatomy for about 200 years and been partially modified by Avicenna (1000 years ago).
  • In 1511, Leonardo da Vinci, Italian Renaissance polymath, first describe the portal hypertension in an illustration in his textbook "De humanis corpore". “... the artery and the vein which go from the spleen to the liver become so large, to block the blood coming from the mesenteric vein; the latter vein dilates and becomes tortuous like a snake, that the liver dries and become like frozen bran, in colour and consistency…”, this presentation was inaccurately described as the cause of portal hypertension.[5]
  • In 1543, Andreas van Wesel (Andrea Vesalio in Latin), Flemish anatomist, described portal system accurately for the first time in his textbook called “De humani corporis fabrica”.[6]
  • In 1650, Francis Glisson, a British physician, demonstrated the portal circulation for the first time, using goat as study model.[7]
  • In 1761, Giovani Battista Morgagni, an Italian anatomist, described the characteristics of cirrhotic liver in his precious textbook named "De sedibus and causis morborum per anatomen indagatis".[8]
  • In 1819, Renè Laennec, a French physician, coined the term cirrhosis in his textbook, from antique Greek words of "Skirros" (hard, fibrotic) and "Kirrhos" (yellowish). He also mentioned his new invention "stethoscope" in the textbook.[6]
  • In 1902, Augustin Gilbert, a French physician, described the properties of collateral circulations from portal to systemic veins and also introduced the term "portal hypertension" for the first time.[6]
  • In 1928, Archibald McIndoe, a New Zealand plastic surgeon, showed that splenomegaly is a result of portal hypertension.[9]
  • In 1937, William Thompson, a Canadian biologist, measured the portal vein pressure for the first time. He did the measurements in open abdomen for both inferior vena cava (IVS) and portal vein.[10]
  • In 1950, Lebon, an Algerian physician, used percutaneous measurement of intrasplenic pressure for diagnosis of portal hypertension for the first time.[11]

Landmark Events in the Development of Treatment Strategies

Approaches

Shunts therapy

Variceal bleeding treatment

Liver transplantation

  • In 1967, Thomas Earl Starzl, an American physician, mentioned that liver transplantation is the only way to treat both portal hypertension and the underlying hepatic disease.[18]

References

  1. By <http://wellcomeimages.org/indexplus/obf_images/17/39/1b25841c1a9217b5965d7ad48851.jpg> Gallery: <http://wellcomeimages.org/indexplus/image/L0063858.html>, CC BY 4.0, <https://commons.wikimedia.org/w/index.php?curid=36231007>
  2. <"https://commons.wikimedia.org/wiki/File%3AF._Glisson%2C_plate_II%2C%22Anatomia_hepatis%22_Wellcome_L0013987.jpg">via Wikimedia Commons
  3. <"https://commons.wikimedia.org/wiki/File%3ARene-Theophile-Hyacinthe_Laennec_(1781-1826)_Drawings_diseased_lungs.jpg">via Wikimedia Commons
  4. Rutkow, Ira (1993). Surgery : an illustrated history. St. Louis: Published by Mosby-Year Book Inc. in collaboration with Norman Pub. ISBN 978-0801660788.
  5. Child, Charles G. (1955). "The Portal Circulation". New England Journal of Medicine. 252 (20): 837–850. doi:10.1056/NEJM195505192522002. ISSN 0028-4793.
  6. 6.0 6.1 6.2 Balducci, Genoveffa; Sterpetti, Antonio V; Ventura, Marco (2016). "A short history of portal hypertension and of its management". Journal of Gastroenterology and Hepatology. 31 (3): 541–545. doi:10.1111/jgh.13200. ISSN 0815-9319.
  7. Magner, Lois (2005). A history of medicine. Boca Raton: Taylor & Francis. ISBN 9780824740740.
  8. Nutton, Vivian (2004). Ancient medicine. London New York: Routledge. ISBN 978-0415086110.
  9. Holzheimer, R (2001). Surgical treatment : evidence-based and problem-oriented. München New York: Zuckschwerdt. ISBN 3-88603-714-2.
  10. Thompson, William P.; Caughey, John L.; Whipple, Allen O.; Rousselot, Louis M. (1937). "SPLENIC VEIN PRESSURE IN CONGESTIVE SPLENOMEGALY (BANTI'S SYNDROME)". Journal of Clinical Investigation. 16 (4): 571–572. doi:10.1172/JCI100883. ISSN 0021-9738.
  11. LEBON J, FABREGOULE M, EISENBETH R, LE GO R (1953). "[Transparietal splenoportography and intrasplenic manometry]". Alger Medicale (in Undetermined). 57 (2): 105–13. PMID 13050585.
  12. Westfal, K (1930). "Uber eine Kompressotbehandlung der Blutungen aus Oesophagus varizen". Deutch Med Wch. 56: 1135–9.
  13. Crafoord, F; Fenckner, P (1939). "New surgical treatment of varicose veins of the esophagus". Acta Oto-laryng. 27: 422–5.
  14. Eck, N V (1877). "On the question of ligature of the portal vein". Voen Med Zh. 130: 1–22.
  15. Banti, Guido (1894). "La splenomegalia can cirrosi del fegato". Sperimentale Firenze: 447–452.
  16. Westaby D, Macdougall BR, Williams R (1985). "Improved survival following injection sclerotherapy for esophageal varices: final analysis of a controlled trial". Hepatology. 5 (5): 827–30. PMID 2993147.
  17. Dzeletovic, Ivana; Baron, Todd H. (2012). "History of portal hypertension and endoscopic treatment of esophageal varices". Gastrointestinal Endoscopy. 75 (6): 1244–1249. doi:10.1016/j.gie.2012.02.052. ISSN 0016-5107.
  18. Brettschneider L, Daloze PM, Huguet C, Groth CG, Kashiwagi N, Hutchison DE, Starzl TE (1967). "SUCCESSFUL ORTHOTOPIC TRANSPLANTATION OF LIVER HOMOGRAFTS AFTER EIGHT TO TWENTY-FIVE HOURS PRESERVATION". Surg Forum. 18: 376–378. PMC 3092670. PMID 21572893.

Template:WH Template:WS