portal hypertension Flashcards
3 primary complications of portal hypertension
GE varices with hemorrhage
acites
hypersplenism
chronic congestive enlargement of the spleen resulting in premature destruction of the red blood cells by the spleen
Banti’s Syndrome
an uncommon condition induced by thrombotic or nonthrombotic obstruction of the hepatic venous outflow and is characterized by hepatomegaly, ascites, and abdominal pain
Budd-Chiari syndrome
increased vasculature of abdominal wall
Caput medusae
most important complication of Portal Hypertension
• Gastroesophageal varices
prevention of 1st episode of bleeding
Primary prophylaxis
prevention of rebleeding in patients who have survived an initial bleeding episode
Secondary prophylaxis
treatment of portal hypertension
Primary prophylaxis
• Management of acute variceal bleeding
• Secondary prophylaxis
chance of a varix to bleed depends upon
size
B1 blockers decrease
Cardiac output
selective blockers reduce only
vascular flow
goals and principles of managing variceal hemorrhage
Reduce portal Hypertension
local control/obliteration of varices
–inserted to mouth, 2 inflatable tubes, one in esophagus, one in stomach, they serve as compression to varices. No decrease in portal pressure
Balloon tamponade
injection of sclerosing substance to prevent bleeding.
Endoscopic sclerotherapy
transaction of entire esophagus, Sugiura procedure
• Surgical devascularization
