GI Disorders - Portal HTN

Question 1

What is Portal HTN? ____mmHg?

Answer 1

persistently elevated BP of >12mmHg in hepatic portal system (HPS)

Question 2

Is pressure extremely low or extremely high?

Answer 2

low

Question 3

Normally, BP in HPS is __-__mmHg.

Answer 3

5-10mmHg

Question 4

In portal HTN, pressure has to be _____

Answer 4

sustained

Question 5

70% of ____ blood goes into the liver via ____ _____ ____ for ________

Answer 5

venous

hepatic portal vein

processing

Question 6

30% of ______ blood goes into the _____ ____ ___

Answer 6

arterial

hepatic arterial vein

Question 7

______ of blood is thru hepatic ____

Answer 7

outflow

veins

Question 8

Etiology of Portal HTN

Answer 8

1. prehepatic, post-hepatic, and intrahepatic obstruction

2. primarily related to cirrhosis

Question 9

What is pre-, post-, and intrahepatic? Examples?

Answer 9

1. prehepatic obstruction refers to vessels before the liver eg hepatic portal vein
   Examples = portal vein thrombosis and external compression
2. post-hepatic obstruction refers to vessels after the livers eg hepatic vein thru liver lobules
   Examples = right sided HF, hepatic vein thrombosis, and veno-occlusive diease
3. intrahepatic obstruction refers to vessels within liver
   Example = alcoholic cirrhosis

Question 10

Where are most portal HTN occurs?

Answer 10

intrahepatic

Question 11

Complications of portal HTN (3):

Answer 11

1. ascites
2. hemorrhage
3. portosystemic shunts

Question 12

What is ascites? What is it caused by?

Answer 12

Ascites is caused by increased CHP which force fluids into body cavity and cause fluid accumulation

Question 13

What cause hemorrhage? Is it life-threatening?

Answer 13

ruptured varices –> massive hemorrhage = life threatening

YESSSSS

Question 14

What are portosystemic shunts and why? The problem?

Answer 14

1. Collateral channels are created between HPS and venous system to relieve pressure d/t engorgement of vessels and increase pressure

collateral channels contain blood components that are destined to be in the liver for processing therefore ammonia and toxins are shunted to general circulation as well

Question 15

What are Caput Medusae?

Answer 15

• Caput medusae are superficial veins around the umbilicus (normally not present upon inspection)
  o d/t portal HTN we can see these veins