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Portal hypertension

In medicine, portal hypertension is hypertension (high blood pressure) in the portal vein and its branches. It is often defined as a portal pressure gradient (the difference in pressure between the portal vein and the hepatic veins) of 12 mm Hg or greater. Many conditions can result in portal hypertension, but it is usually the result of cirrhosis of the liver. more...

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Medicines

Signs and symptoms

Consequences of portal hypertension are caused by blood being forced down alternate channels by the increased resistance to flow through the portal system. They include:

  • Ascites (free fluid in the peritoneal cavity)
  • Esophageal varices (dilated veins in the wall of the esophagus that are prone to bleed)
  • Hemorrhoids
  • Hepatic encephalopathy
  • Palmar erythema
  • Clubbing
  • Distended abdominal wall veins (caput medusae)
  • Increased risk of spontaneous bacterial peritonitis
  • Increased risk of hepatorenal syndrome

Treatment

Treatment with a non-selective beta blocker is generally commenced once portal hypertension has been diagnosed, typically with propranolol. In acute or severe complications of the hypertension, such as bleeding varices, intravenous terlipressin (an antidiuretic hormone analogue) is commenced to decrease the portal pressure.

Transjugular intrahepatic portosystemic shunting is the creation of a connection between the portal and the venous system. As the pressure over the venous system is lower than over a hypertensive portal system, this would decrease the pressure over the portal system and a decreased risk of complications.

The most definitive treatment of portal hypertension is a liver transplant.

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Portal Hypertension: Diagnostic Imaging and Imaging-Guided Therapy (Medical Radiology / Diagnostic Imaging) $238.99 Portal Hypertension: Pathobiology, Evaluation, And Treatment (Clinical Gastroenterology) $100.00
Portal Hypertension IV - Proceedings of the 4th Baveno International Consensus Workshop $62.97 Medical and Surgical Problems of Portal Hypertension (Proceedings of the Serono Symposia) $17.00
Portal Hypertension III: Proceedings of the Third Baveno International Consensus Workshop on Definitions, Methodology, and Therapeutic Strategies $84.05 The Hepatic Circulation and Portal Hypertension $14.99
Diagnostic dilemma.(Brief Article) : An article from: Pediatric News $5.95 Portal Hypertension: A Multidisciplinary Approach to Current Clinical Management $32.27
Portal Hypertension II: Definitions, Methodology, and Therapeutic Strategies $49.61 Portal Hypertension in the 21st Century $83.48

Portal hypertension; pathobiology, evaluation, and treatment
Portal hypertension; pathobiology, evaluation, and treatment. Ed. by Arun J. Sanyal and Vijay H. Shah. Humana Press Inc. 2005 515 pages $165.00 ...
Ascites, encephalopathy, and other conditions - Portal Hypertension, part 2 - ABC of Diseases of Liver, Pancreas, and Biliary System
The diagnosis and treatment of several complications of portal hypertension are discussed. Portal hypertension is high blood pressure in the portal vein, ...
Varices - Portal Hypertension, part 1 - ABC of Diseases of Liver, Pancreas, and Biliary System
The treatment of esophageal varices is discussed. Varices are enlarged blood vessels that can bleed. Varices in the esophagus are often caused by liver ...
Management of portal hypertension and esophageal varices in alcoholic cirrhosis - includes patient information sheet
Portal hypertension is a frequent consequence of liver disease, especially alcoholic cirrhosis. Unabated elevations in portal pressure may presage an esophageal ...
Portopulmonary hypertension : a tale of two circulations
Pulmonary involvement is common in patients with portal hypertension and can manifest in diverse manners. Changes in pulmonary arterial resistance, manifesting either as the hepatopulmonary syndrom
Treatment of portopulmonary hypertension with oral Sildenafil
PURPOSE: Pulmonary arterial hypertension (PAH) in the setting of portal hypertension, or Porto-pulmonary Hypertension (PPHTN), has an estimated prevalence ...
Treatment of secondary pulmonary arterial hypertension with endothelin receptor blockade
PURPOSE: Secondary pulmonary arterial hypertension (SPAH) is an adverse outcome of a variety of systemic disorders. These include collagen vascular diseases, chronic thromboembolism, human immunode
Pulmonary hypertension in patients with idiopathic pulmonary fibrosis
Study objectives: To determine the impact on survival and clinical correlates of pulmonary hypertension (PH) occurring in patients with idiopathic pulmonary ...

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