Portal Hypertension Flashcards
What is are the 7 causes of cirrhosis?
- Chronic alcoholism
- Hepatitis B
- Hepatitis C
- Hemochromatosis
- Wilson’s disease
- Biliary cirrhosis
- Sclerosing cholangitis
What is cirrhosis?
Disease where the liver becomes hard, shrunken, scarred, and laced with thick bands of fibrotic tissue.
What is hemochromatosis?
Iron overload
What is Wilson’s Disease?
Altered copper metabolism
What are the 3 major complications of cirrhosis?
- Metabolic abnormalities
- Portal hypertension
- Hepatic encephalopathy
What 2 metabolic abnormalities occur in cirrhosis?
- Albumin and cholesterol levels fall
2. Prothrombin time increases
What is the cause of metabolic abnormalities in cirrhosis?
Inability of the liver to manufacture proteins in the coagulation cascade
Decreased plasma K+ and Na+ levels usually lead to the onset of? What is the name of this syndrome?
Renal failure. This is called hepatorenal syndrome.
How does cirrhosis affect blood flow?
It causes increased resistance to the blood flow coming into the liver.
When does portal hypertension arise? (2)
- Portal venous pressure rises.
2. Increased pressure in splanchnic capillaries.
What is the end result of portal hypertension?
Abdominal edema
What is the advanced stage of abdominal edema?
Ascites
What is ascites?
Fluid accumulation in the peritoneal cavity
As the portal pressure rises, a portion of the portal blood begins to flow through and dilate the?
Portal anastomoses
Where are the anastomoses located?
- Esophagus
- Umbilicus
- Rectum
- Retroperitoneum
What is esophageal varices?
When dilation of the vessels in the esophagus leads to burst and cause hemorrhage.
What is sclerotherapy?
Injection of sclerosing agents in someone with esophoageal varices.
What are the 4 complications/side effects of sclerotherapy?
- Perforation
- Stricture formation
- Infection
- Aspiration
How can you prevent rupture of varices is some patients?
Place a hepatic portosystemic shunt
How do you put in a hepatic portosystemic shunt?
- Go through jugular vein
- Go into liver
- Put stent between branch of hepatic and portal veins
What is the end result of a hepatic portosystemic shunt?
Allow portal blood to flow into the vena cava
What is portacaval shunt?
A shunt linking the portal vein and the vena cava.
What is a downside of a portacaval shunt?
Hepatic encephalopathy
What is a splenorenal shunt?
A shunt that diverts only a portion of the blood away from the liver. (most popular method)
