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April 1956

Surgical Experiences in Portal HypertensionA Review of Nineteen Cases from Brooke Army Hospital

Author Affiliations

U. S. Army Fort Sam Houston, Texas
From the Surgical Service, Brooke Army Hospital (Majors Fahy and Schirmer); Chief, Department of Surgery and Chief, General Surgery Service, Brooke Army Hospital; Chief of Clinical Surgery, Medical Field Service School; Consultant in Surgery, Fourth Army Headquarters; Professor of Surgery, Graduate School, Baylor University (Col. Bowers).

AMA Arch Surg. 1956;72(4):583-594. doi:10.1001/archsurg.1956.01270220031004

INTRODUCTION  The literature dealing with surgical aspects of portal hypertension in the past few years has been voluminous, and the ideas expressed have been sufficiently divergent that some doubt has arisen as to the validity of the feeling that portacaval anastomosis is beneficial and worth while. Our work in this complicated field has been predicated on the philosophy that cirrhosis of the liver or some other cause of portal hypertension is outside the scope of surgical attack and that our narrow sphere of usefulness to the patient lies in prevention of death from esophageal varix hemorrhage secondary to the obstruction to portal flow. Thus, our approach is a mechanical one, based on an attempt to reduce portal pressure to the point where esophageal varices disappear or have such a reduced pressure that they are unlikely to erode or rupture and bleed. We therefore have put great emphasis on pre- and

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