HEPATIC HEMODYNAMICS IN A PATIENT WITH NODULAR REGENERATIVE HYPERPLASIA

Nodular regenerative hyperplasia of the liver is an uncommon condition , Approximately 50% of these patients develop portal hypertension, Few previous reports document the site of increased resistance to blood f low within the liver in this disorder, We measured Doppler waveform pa tterns of the right hepatic vein by pulsed Doppler ultrasonography and portal, wedged hepatic, and free hepatic venous pressure by intraveno us catheter before and after splenectomy in a 47-yr-old woman with nod ular regenerative hyperplasia who presented with portal hypertension a nd pancytopenia, Nodular regenerative hyperplasia was histologically c onfirmed, Pre- and postoperative measures indicated a marked differenc e between wedged hepatic venous pressure and free hepatic venous press ure, whereas there was little difference between portal venous pressur e and wedged hepatic venous pressure, Doppler waveform patterns of the right hepatic vein showed an unclear pulsatile flow pattern with a de creasing reversed phase, The above data suggest that portal hypertensi on in nodular regenerative hyperplasia is primarily sinusoidal, simila r to that seen with cirrhosis.