Portal hypertension is typically secondary to what liver condition?

• A. Cirrhosis
• B. Cholecystitis
• C. Hepatic cysts
• D. Acute hepatitis A

Answer: (A)

Portal hypertension is driven by increased resistance to blood flow through the liver. The most common situation is cirrhosis, where fibrotic scarring and regenerative nodules distort hepatic architecture and impede intrahepatic blood flow, raising portal venous pressure. This elevated resistance explains the classic consequences like variceal bleeding and ascites. Inflammation of the gallbladder (cholecystitis) doesn’t markedly affect portal venous resistance. Hepatic cysts, unless extremely extensive, don’t create the level of intrahepatic resistance seen with cirrhosis. Acute hepatitis A is an acute inflammatory process and portal hypertension typically arises from chronic liver disease rather than a short-lived acute infection. So, cirrhosis is the typical cause of portal hypertension.