The value of computed tomography in the diagnosis of the prehepatic portal hypertension.

: The dynamic computed tomography (CT) is used by the authors in a complex system of investigations. It is preceded by a diagnosis stage which determines the "normal" character of the liver and it is followed by the angiographic exploration for the cases with surgical indication. 36 patients with CT diagnosis of prehepatic portal hypertension were studied; from these patients, 24 had an angiographic confirmation and 16 of them were operated. The most valuable CT signs which have been found by the authors were: the study of the portal vein at the hilum level and in the distal parapancreatic region, the hypoplasia of the left hepatic lobe and the absence of the ascites. The other signs were considered less important, only the localization of the porto-systemic shunts being to a certain degree important for surgery. It is underlined the early age of the patients (69% are under 30 years old). The diagnosis concordance was in the studied group 100% for the positive diagnosis of the syndrome, but only 79% for the localization of the obstruction. CT is the most innocuous diagnostic procedure which obtains a maximum of data on the portal system morphology.