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Portal Hypertension: Causes & Management

Portal hypertension is defined as increased pressure in the portal vein above normal levels. It is usually caused by obstruction in the portal veins draining into the inferior vena cava, which can be due to pre-hepatic, hepatic, or post-hepatic causes. Common manifestations include esophageal varices, hemorrhoids, splenomegaly, and hypersplenism. Management involves resuscitation of blood volume and pressure, diagnosis typically using endoscopy, and specific treatments such as vasopressin or endoscopic variceal sclerosis.

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Dr. Surendra Singh
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465 views10 pages

Portal Hypertension: Causes & Management

Portal hypertension is defined as increased pressure in the portal vein above normal levels. It is usually caused by obstruction in the portal veins draining into the inferior vena cava, which can be due to pre-hepatic, hepatic, or post-hepatic causes. Common manifestations include esophageal varices, hemorrhoids, splenomegaly, and hypersplenism. Management involves resuscitation of blood volume and pressure, diagnosis typically using endoscopy, and specific treatments such as vasopressin or endoscopic variceal sclerosis.

Uploaded by

Dr. Surendra Singh
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

Portal hypertension is defined as a

increase in portal vein pressure above the


normal level of 5 to 10 mm Hg. In
established cases of portal hypertension,
direct portal pressure measurement may be
elevated to 15 mm Hg or even more.
Portal
hypertension is due to obstruction
somewhere in the portal veins draining
into the inferior venacava (post- hepatic)

 The Manifestation are:


 Oesophegeal Varicosity
 Haemorrhoids
 Splenomegaly &
Hypersplenism
 Liver Failure
 Pre – hepatic causes:– 20%
Congenital atresia or Hypoplasia.
Trauma
Tumor
Isolated spleenic vein thrombosis.

 Hepatic causes:– 80%.


Nutritional cirrhosis.
Postnecrotic cirrhosis.
Billary cirrhosis.
Haemochromatosis.
Wilson's disease.
 Post Hepatic:– Rare
Budal chair syndrome.
Right sided heart failure.
 Pre-hepatic causes  Hepatic Causes  Post- Hepatic Cause
 Management three stages:
 Resuscitation:
 Blood volume should be maintained.

 Saline should be avoided because of ascites.

 Pulse rate, blood pressure should be monitored.

 Gastric acid secretion should be decreased.

 Diagnosis:
 Endoscopy
Specific Treatment:
 Vasopressin.

 Endoscopic Variceal Sclerosis.

 Balloon Tamponade.
 Shock

 Clotting Problems

 Ascites

 Liver Failure

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