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Gastroenterologie > Portale hypertensie > Flashcards

Portale hypertensie Flashcards

1
Q

Definitie portale hypertensie?

A
  • Portal hypertension is defined as a hepatic venous pressure gradient (HVPG) of ≥ 6 mm Hg.
  • HVPG > 10 mm Hg is clinically significant
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2
Q

Oorzaken portale hypertensie?

A
  • Prehepatisch: v. porta thrombose, v. splenica thrombose
  • Hepatisch: cirrose, meta’s
  • Posthepatisch: hartfalen, constructieve pericarditis,
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3
Q

Kliniek portale hypertensie?

A 
	Gastro-intestinale bloedingen 
	Maag en slokdarm varices 
	Ascites
	Spontane bacteriële peritonitis (SBP)
	Hepatorenaal syndroom (HRS) 
	Hepatopulmonaal syndroom (HPS) 
	Portosystemische encefalopathie --> toxische stoffen die in normale omstandigheden werden gefilterd door de lever gaan nu rechtstreeks naar hersenen.
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4
Q

Bo portale hypertensie?

A

 Endoscopisch onderzoek –> opsporen en behandelen van oesophagale varices
 Echografie lever
 Abdominale CT

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4
Q

Bo portale hypertensie?

A

 Endoscopisch onderzoek –> opsporen en behandelen van oesophagale varices
 Echografie lever
 Abdominale CT

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5
Q

Behandeling portale hypertensie?

A
  • eerste lijns medicatie: non-selectieve beta blokkers

- TIPSS plaatsen

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6
Q

Waarvoor staat TIPSS?

A

Transjugulaire intrahepatische portosystemische shunt

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7
Q

Mechanisme TIPSS?

A

Rechtstreekse stentplaatsing tussen v. porta en v. cava inferior

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7
Q

Mechanisme TIPSS?

A

Rechtstreekse stentplaatsing tussen v. porta en v. cava inferior

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8
Q

Contra indicatie TIPSS?

A

Encefalopathie –> toxische stoffen worden nu helemaal niet meer gefilterd door de lever en gaan rechtstreeks naar hersenen.

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9
Q

Hoe doen we aan preventie voor varicesbloedignen?

A

1x/jaar endoscopie –> zo hoog-risico Carices: ligatuur en non selectieve beta blokkers

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10
Q

Wat is sinestrale portale hypertensie?

A

is een zeer zeldzame (maar levensbedreigende) oorzaak van bovenste maagbloedingen.
Veroorzaakt door occlusieve thrombus in v. splenica –> vorming van lieno-gastrische varices

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Gastroenterologie (83 decks)

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