Portal Hypertension and Varices Flashcards
What are varices?
Submucosal venous dilatation secondary to increased portal pressures
What are the three categories for causes of portal HTN?
Pre-hepatic, intra-hepatic, post-hepatic
What is a pre-hepatic cause of portal HTN?
Portal vein thrombosis
What are intra-hepatic causes of portal HTN?
Cirrhosis, schistosomiasis, Budd-Chiari syndrome
What are post-hepatic causes of portal HTN?
RH failure, IVC obstruction
What are risk factors for portal HTN?
Cirrhosis, congestive heart failure
What two main investigations would you do?
Upper GI endoscopy, hepatic venous pressure gradient
How do you manage oesophageal varices surgically?
Endoscopic band ligation
What management is there for resistant varices?
Transjugular intrahepatic porto-systemic shunt
What are complications of portal HTN?
Ascites, oesophageal varices, hepatic encephalopathy
What are complications of varices
Bleeding, shock
How do oesophageal varices cause melaena?
When oesophageal varices rupture they cause haematemesis, some blood is digested and passed with stool, resulting in melaena
How would you manage portal HTN?
Beta blockers and nitrates
