Lesson 5C Flashcards
What is splenomegaly associated with? (3)
- Leukemia
- Lymphoma
- Portal hypertension
- any disease that involves abnormal red blood cells being destroyed
What are important signs of portal hypertension? (2)
- Enlarged spleen
2. Caput Medusae
What does portal vein thrombosis cause? (5)
- Reduced blood supply to the liver
- Pancreatitis
- Cirrhosis
- Diverticulitis
- Cholangiocarcinoma
What does cavernous transformation of the portal vein occurs in?
Long standing PVT
Cavernous transformation
Bridging collaterals form around the occlusion
What happens with portal hypertension?
The hepatic arteries will enlarge and become tortuous exhibiting aliasing frequency shifts
What happens as portal venous flow to the liver decreases?
Arterial flow increases
What does increased arterial flow occurs with?
Development of large collaterals and hepatopetal flow
What are symptoms of portal hypertension? (3)
- Gastrointestinal bleeding
- Ascites
- Encephalopathy
Gastrointestinal bleeding
Black tarry stools and vomiting blood
- rupture and hemorrhage from varices
Encephalopathy
Confusion and forgetfulness are caused by poor liver function
What are reduced with encephalopathy? (2)
- Platelets
- clotting - White blood cells
What is the treatment for portal hypertension?
Most causes of portal hypertension cannot be treated
What does the treatment focus on for portal hypertension?
Preventing or managing the complications such as bleeding from varices
TIPS
Transjugular intrahepatic portosystemic shunt
Transjugular intrahepatic portosystemic shunt
A stent is placed in the middle of the liver that connects the hepatic vein with the portal vein to reroute blood flow in the liver to help relieve pressure in abnormal veins
What are TIPS complications? (7)
- Intraperitoneal hemorrhage
- Shunt thrombosis
- Neck hematoma
- Compromise of hepatic blood supply
- Failed stent deployment, expansion, migration or fracture
- Biliary obstruction
- Delayed shunt stenosis, HV stenosis
What happens when you put colour flow on the site of stenosis?
Aliasing
What should you evaluate when you have a stent?
The hepatic vein distal to it
DSRS
Distal splenorenal shunt
What does distal splenorenal shunt do? (3)
- Connects the vein from the spleen to the vein from the left kidney
- Reduces pressure in varices
- Helps control bleeding
What are 2 other collateral paths?
- Liver hilum
2. Splenic hilum
