Portal Vein HTN

Question 1

What is portal vein HTN?

Answer 1

Changes in liver causes compression & destruction of portal and hepatic sinusoids
Results in ⬆️capillary pressure & obstruction of normal flow through portal system

Question 2

Common areas of collateral circulation

Answer 2

• lower esophagus
• anterior abdominal wall
• parietal peritoneum
• rectum
• Capital Medusae (ring of varies around umbilicus)
• hemorrhoids

Question 3

Pharmacological management Portal vein HTN

Answer 3

• propranolol (⬇️BP) - Atenolol (patient who are asthmatic)
• PPI ( ppx stress ulcers)
• Vitamin K (⬆️pressure from HTN can cause erosion. Vit k clots)
• Diuretics: Spirolactone (K+ sparring, gets rid of ADH)
• H2 blocker (ppx)
• Lactulose - Magnesium Sulfate

Question 4

Nutritional considerations for portal vein HTN

Answer 4

*High calorie diet
⬆️ Carbs
⬇️ Protein 
⬇️ Salt : 2 gm restriction 
⬇️ Fat