portal hypertension

Question 1

what is portal hypertension?

Answer 1

• complication of cirrhosis
• increased pressure in portal venous system

Question 2

what are the causes of portal hypertension?

Answer 2

1. pre- hepatic
2. intra hepatic
3. post- hepatic

Question 3

how does pre-hepatic LF cause portal hypertension?

Answer 3

thrombosis of portal vein

Question 4

how does intra-hepatic LF cause portal hypertension?

Answer 4

• cirrhosis ( most common in the UK)
• schistosomiasis -( disease caused by parasitic worms)
• budd chiari syndrome ( hepatic vein obstruction)

Question 5

how does post hepatic LF cause portal hypertension?

Answer 5

• RHS heart failure
• Constrictive pericarditis
• IVC obstruction

Question 6

what are the symptoms of portal hypertension?

Answer 6

• usually asymptomatic
• present when oesophageal varices rupture

Question 7

describe the pathology behind portal hypertension

Answer 7

1. normal pressure 5-8 mmHg in portal vein
2. cirrhosis= increased resistance to flow
3. therefore splanchic dilation and compensatory increased CO
4. fluid overload in portal vein
5. results in collateral blood shunting to gastroesophageal veins
6. become oesophageal varices at cardia and lower oesaphagus