Portal hypertension historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
In 1511, Leonardo da Vinci, Italian Renaissance polymath, first describe the portal hypertension in an illustration in his textbook "De humanis corpore". “... the artery and the vein which go from the spleen to the liver become so large, to block the blood coming from the mesenteric vein; the latter vein dilates and becomes tortuous like a snake, that the liver dries and become like frozen bran, in colour and consistency…”, he mentioned mistakenly the portal hypertension as the outcome of this presentation.
Historical Perspective
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Discovery
- Herophilus was the first scientist that explained the portal venous system in human body in IV century B.C. “…nature made special veins which are dedicated to the nourishment of the intestine and they do not pass to the liver; these veins end in glandular bodies, while all the other veins are carried back to the portae...”, he mentioned.[2]
- In 1319, Mondino de Liuzzi (Mundinus), an Italian surgeon, published the textbook named "Anhotomia" and showed the anatomy of liver vascular system for the first time. The book was the most reliable textbook of anatomy for about 200 years and been partially modified by Avicenna, 1000 years ago.
- In 1511, Leonardo da Vinci, Italian Renaissance polymath, first describe the portal hypertension in an illustration in his textbook "De humanis corpore". “... the artery and the vein which go from the spleen to the liver become so large, to block the blood coming from the mesenteric vein; the latter vein dilates and becomes tortuous like a snake, that the liver dries and become like frozen bran, in colour and consistency…”, he mentioned mistakenly the portal hypertension as the outcome of this presentation.[3]
- In 1543, Andreas van Wesel (Andrea Vesalio in Latin), Flemish anatomist, has described portal system accurately for the first time in his textbook called “De humani corporis fabrica”.[4]
- In 1650, Francis Glisson, a British physician, demonstrated the portal circulation for the first time, using goat as study model.[5]
- In 1761, Giovan Battista Morgagni, an Italian anatomist, described the characteristics of cirrhotic liver in his precious textbook named "De sedibus and causis morborum per anatomen indagatis".[6]
- In 1819, Renè Laennec, a French physician, coined the name cirrhosis in his textbook, from antique Greek words of "Skirros" (hard, fibrotic) and "Kirrhos" (yellowish). He also mentioned his new invention "stethoscope" in the textbook.[4]
- In 1902, Augustin Gilbert, a French physician, describe the properties of collateral circulations from portal to systemic veins and also introduced the term "portal hypertension" for the first time.[4]
- In 1928, Archibald McIndoe, a New Zealand plastic surgeon, showed that splenomegaly is the result of portal hypertension.[7]
- In 1937, William Thompson, a Canadian biologist, measured the portal vein pressure for the first time. He did the measurements in open abdomen for both inferior vena cava (IVS) and portal vein.[8]
- In 1950, Lebon, an Algerian physician, used percutaneous measurement of intrasplenic pressure for diagnosis of portal hypertension, for the first time.[9]
Landmark Events in the Development of Treatment Strategies
Approaches
- In 1930, Westfal, a German physician, used some endoscopic balloons to compress and treat bleeding esophageal varices.[10]
- In 1939, Crafoord and Fenckner, Dutch cardiac surgeons, used sclerosing agents (quinine solutions) to treat the esophageal varices via endoscopy. The procedure was rarely used because of high rates of rebleeding.[11]
Shunts therapy
- In 1877, Nicholas Eck, a German physician, did the first portocaval shunt to treat the liver congestion in dogs.[12]
- In 1894, Guido Banti, an Italian physician, postulated the splenectomy as an option for treatment of portal hypertension.[13]
- In 1945, Allan Whipple, an American surgeon, reported some cases of the portal hypertension treatment with shunts. He eventually tried shunts between different mesenteric veins. Finally, he found portocaval shunt as the best choice.
Variceal bleeding treatment
- In 1985, David Westaby, a British gastroenterologist, postulated that variceal sclerosing therapy is an better option than pharmacotherapy in the treatment of portal hypertension.[14]
- In 1980s, researchers have shown that endoscopic sclerotherapy is more efficient than surgical shunting in preventing recurrent variceal bleeding.[15]
Liver transplantation
- In 1967,Thomas Earl Starzl, an American physician, mentioned that liver transplantation is the only way to treat both portal hypertension and the underlying hepatic disease.[16]
References
- ↑ By <http://wellcomeimages.org/indexplus/obf_images/17/39/1b25841c1a9217b5965d7ad48851.jpg> Gallery: <http://wellcomeimages.org/indexplus/image/L0063858.html>, CC BY 4.0, <https://commons.wikimedia.org/w/index.php?curid=36231007>
- ↑ Rutkow, Ira (1993). Surgery : an illustrated history. St. Louis: Published by Mosby-Year Book Inc. in collaboration with Norman Pub. ISBN 978-0801660788.
- ↑ Child, Charles G. (1955). "The Portal Circulation". New England Journal of Medicine. 252 (20): 837–850. doi:10.1056/NEJM195505192522002. ISSN 0028-4793.
- ↑ 4.0 4.1 4.2 Balducci, Genoveffa; Sterpetti, Antonio V; Ventura, Marco (2016). "A short history of portal hypertension and of its management". Journal of Gastroenterology and Hepatology. 31 (3): 541–545. doi:10.1111/jgh.13200. ISSN 0815-9319.
- ↑ Magner, Lois (2005). A history of medicine. Boca Raton: Taylor & Francis. ISBN 9780824740740.
- ↑ Nutton, Vivian (2004). Ancient medicine. London New York: Routledge. ISBN 978-0415086110.
- ↑ Holzheimer, R (2001). Surgical treatment : evidence-based and problem-oriented. München New York: Zuckschwerdt. ISBN 3-88603-714-2.
- ↑ Thompson, William P.; Caughey, John L.; Whipple, Allen O.; Rousselot, Louis M. (1937). "SPLENIC VEIN PRESSURE IN CONGESTIVE SPLENOMEGALY (BANTI'S SYNDROME)". Journal of Clinical Investigation. 16 (4): 571–572. doi:10.1172/JCI100883. ISSN 0021-9738.
- ↑ LEBON J, FABREGOULE M, EISENBETH R, LE GO R (1953). "[Transparietal splenoportography and intrasplenic manometry]". Alger Medicale (in Undetermined). 57 (2): 105–13. PMID 13050585.
- ↑ Westfal, K (1930). "Uber eine Kompressotbehandlung der Blutungen aus Oesophagus varizen". Deutch Med Wch. 56: 1135–9.
- ↑ Crafoord, F; Fenckner, P (1939). "New surgical treatment of varicose veins of the esophagus". Acta Oto-laryng. 27: 422–5.
- ↑ Eck, N V (1877). "On the question of ligature of the portal vein". Voen Med Zh. 130: 1–22.
- ↑ Banti, Guido (1894). "La splenomegalia can cirrosi del fegato". Sperimentale Firenze: 447–452.
- ↑ Westaby D, Macdougall BR, Williams R (1985). "Improved survival following injection sclerotherapy for esophageal varices: final analysis of a controlled trial". Hepatology. 5 (5): 827–30. PMID 2993147.
- ↑ Dzeletovic, Ivana; Baron, Todd H. (2012). "History of portal hypertension and endoscopic treatment of esophageal varices". Gastrointestinal Endoscopy. 75 (6): 1244–1249. doi:10.1016/j.gie.2012.02.052. ISSN 0016-5107.
- ↑ Brettschneider L, Daloze PM, Huguet C, Groth CG, Kashiwagi N, Hutchison DE, Starzl TE (1967). "SUCCESSFUL ORTHOTOPIC TRANSPLANTATION OF LIVER HOMOGRAFTS AFTER EIGHT TO TWENTY-FIVE HOURS PRESERVATION". Surg Forum. 18: 376–378. PMC 3092670. PMID 21572893.
