Portal HTN

Question 1

portal vein normal pressure

Answer 1

5-8mmhg

Question 2

Portal hypertension

Answer 2

> 10-12mmhg

Question 3

Some of collaterals

Answer 3

Left renal v
Diaphragm
Retroperitoneum
V

Question 4

Varices incidence

Answer 4

90% of cirrhotic
1/3 will bleed with 25%mortality

Question 5

Specific managment of varices

Answer 5

Urgent Endoscopic (within 2-12h) therapy
1. Banding
2. Sclerotherapy
• IV vasoconstrictors
• TIPS
• Surgical shunting

Question 6

Acute varices TTT oof choice

Answer 6

sclerotherapy and banding

Question 7

Examples of vaso pressor

Answer 7

Terlipressin.
■ Somatostatin.
■ Octreotide.

Question 8

Balloon tamponade CI

Answer 8

Severe hge
Can be left up to 12h

Question 9

Emergency surger(last option)

Answer 9

TIPS
• Esophageal transection and ligation
Acute portosys shunt

Question 10

Varices prevention

Answer 10

NON SELECTIVE B OR ALPHA AND BETA BLOCKER(CArvidelol)
1)Oral propranolol
(*decrease in cardiac output (B1),
*blockade of β2 vasodilator receptors on the
splanchnic A)1st line

2)Endoscopic ablation(Banding

Question 11

Major risk of shunts

Answer 11

Encephalopathy

The ‘shunts’ performed are usually an end-to-
side portocaval anastomosis or a selective
distal splenorenal

Question 12

Devascularization procedures including
esophageal transection

Answer 12

do not produce
encephalopathy

Question 13

Intrahepatic portal HTN

Answer 13

Schistosomiasis
PBC

Question 14

Post hepatic obstruction

Answer 14

IVC
VENO OCCLOSIVE
budd-chiari syndrome

Question 15

PrehePatic obs

Answer 15

Portal vein thrombosis