[Hepatosplenic granulomatosis with portal hypertension].

A 40-year-old female patient was admitted with bleeding from esophageal varices. The histology of liver and spleen showed granulomatous infiltrations that had developed without symptoms so far. The portal hypertension and a thrombopenic bleeding diathesis gave rise to the establishment of a splenorenal shunt with exstirpation of the spleen. By this the patient could be cured symptomatically, as three years after the acute episode liver functions are still normal. In the light of this case, pathogenesis, the variety of etiologies and the clinical courses of granulomatous liver diseases are discussed in detail with regard to the differential diagnosis.