Idiopathic Portal Hypertension (Hepatoportal Sclerosis)

  • Kunio Okuda
  • Hiroshi Obata


Toward the end of the last century, Band [1] called attention to a disorder characterized by anemia and splenomegaly not associated with any known hematological disease. He emphasized the histological changes in the spleen which he called “fibroadenia”, and proposed that the disease presenting this morphologic feature be called “morbus Banti”. He divided the natural history of this disease into (a) the anemia phase with splenomegaly, (b) a transitional phase with urobilinuria, discoloration of the skin, and increasing gastrointestinal bleeding, and (c) and ascitic phase with atrophy of the liver terminating in death from hemorrhage or hepatic failure. According to him, the spleen was the primary seat of the disease, and anemia, hepatic cirrhosis, and sclerosing endophlebitis of the splenic and portal veins were the consequences. However, it soon became clear that fibroadenia of the spleen was not a specific change, being seen in various other diseases. In 1905, Naunyn [2] suggested that Banti’s disease represented liver cirrhosis with secondary splenomegaly and bleeding diathesis, and suggested that this disorder be called “splenomegalic liver cirrhosis”. This concept was supported by Eppinger [3], McNee [4], and others. The other theory put forward by Dock and Warthin [5] was a vascular and circulatory one which maintained that splenomegaly in patients who fulfilled the clinical criteria of Banti’s disease was a consequence of circulatory disturbances, particularly in patients with thrombophlebitic changes along the portal axis. This theory had advantages over the primary splenic disease concept when it was recognized that the histology of Banti spleen was mainly congestive, and that intrasplenic pressure was markedly elevated. Eppinger [3] among others advised that the term Banti’s disease be abandoned.


Portal Hypertension Portal Fibrosis Idiopathic Portal Hypertension Portal Venous Flow Portal Vein Pressure 
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Copyright information

© Springer Japan 1991

Authors and Affiliations

  • Kunio Okuda
    • 1
  • Hiroshi Obata
    • 2
  1. 1.Department of MedicineChiba University School of MedicineChiba, 280Japan
  2. 2.Institute of GastroenterologyTokyo Women’s Medical CollegeTokyo, 162Japan

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