American Board of Pathology (ABPath) 2025 – 400 Free Practice Questions to Pass the Exam

The most common cause of portal hypertension is cirrhosis. Cirrhosis refers to the advanced scarring of the liver resulting from various forms of liver diseases, including chronic hepatitis and prolonged exposure to toxins, such as alcohol.

In cases of cirrhosis, liver tissue is replaced with fibrotic tissue, which disrupts normal blood flow through the liver. This leads to increased pressure in the portal venous system, known as portal hypertension. As the liver becomes increasingly damaged, the blood vessels may become narrowed due to the fibrotic changes, further contributing to elevated pressure and the resultant complications associated with portal hypertension, such as esophageal varices, ascites, and splenomegaly.

While hepatitis, alcoholism, and vascular obstruction may contribute to liver disease or portal hypertension in some cases, they are not standalone conditions that most commonly lead to this complication. Hepatitis can lead to cirrhosis, and alcoholism can cause liver damage, but cirrhosis specifically encapsulates the end-stage progression of these diseases where portal hypertension is most likely to occur.