Pathogenesis of portal hypertension in alcoholic liver disease

Morphometric investigations of ballooning hepatocyte and perivenular fibrosis were performed to clarify the pathogenesis of portal hypertension in alcoholic liver disease (ALD). Liver biopsies and measurements of intrahepatic portal vein pressure were performed simultaneously in 8 patient with ALD immediately after abstinence and after liver function test improved. The surface area of hepatocytes and the thickness of fibrous tissue around terminal hepatic vein were analysed morphometrically. The swelling of hepatocytes were more prominent in pericentral zone compared with that in periportal zone. In the patients with ALD with mild fibrosis, the decrease of intrahepatic portal vein pressure were observed in proportion to the improvement of the swelling of hepatocytes after long term abstinence. On the other hand, in the patients with ALD of prominent fibrosis, there was no remarkable change in intrahepatic portal vein pressure in spite of the improvement of swelling of hepatocytes after long term abstinence. The present results suggest that in the patients with ALD in early stage including fatty liver the swelling of hepatocytes is the main factor in the pathogenesis of portal hypertension.