Resorption bei portaler Hypertension

Abstract

A brief introductory review of current concepts of intestinal absorption of nutrients is followed by a discussion of studies in dogs which clearly indicate, that the height of the portal pressure does affect the absorption rate of passively absorbed substances. The retrospective evaluation of protocols of 162 patients who underwent liver vein catheterization in our clinic, however, does not provide any evidence for impaired intestinal absorption of d-xylose in patients with proven portal hypertension. Absorption of vitamin B₁₂ also was normal. Furthermore, although serum concentrations of albumin, cholesterol, triglycerides, calcium and clotting factors which affect prothrombin time were significantly lower in patients with portal hypertension, these concentrations correlated only poorly with wedged hepatic venous pressure. It is concluded therefore, that in man intestinal absorptive processes are not impaired by portal hypertension per se. Steatorrhea which is found frequently in patients with cirrhosis of the liver most likely is due to several factors, among which derangement of bile salt metabolism, exocrine pancreatic insufficiency and morphological changes of intestinal mucosa have been implicated.