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The first is the use of beta-blockers, which reduce portal pressures. Non-selective beta blockers (such as propranolol and nadolol) have been used to decrease the pressure of the portal vein in patients with esophageal varices, and have been shown to regress portal hypertensive gastropathy that has been worsened by medical treatment of varices. [5]
Gastric varices are dilated submucosal veins in the lining of the stomach, which can be a life-threatening cause of bleeding in the upper gastrointestinal tract.They are most commonly found in patients with portal hypertension, or elevated pressure in the portal vein system, which may be a complication of cirrhosis.
A dilated portal vein (diameter of greater than 13 or 15 mm) is a sign of portal hypertension, with a sensitivity estimated at 12.5% or 40%. [18] On Doppler ultrasonography, a slow velocity of <16 cm/s in addition to dilatation in the main portal vein are diagnostic of portal hypertension. [19]
In portal hypertension, venous resistance is increased within the portal venous system; when the pressure in the portal venous system increases above that of the systemic, blood is shunted through the portosystemic anastomoses. The shunting of blood and consequential increase of pressure through the collateral veins causes the varicosities.
Axial and coronal images in the portal venous phase. Increased pressure in the sublobular branches of the hepatic veins causes an engorgement of venous blood, and is most frequently due to chronic cardiac lesions , especially those affecting the right heart (e.g., right-sided heart failure ), the blood being dammed back in the inferior vena ...
It is a cause of portal hypertension and can cause bowel ischemia sometimes leading to bowel infarction. Diverticulitis (26.5%) and acute appendicitis (22%) are the two most common causes. Pylephlebitis is caused by a single pathogen in 43% of cases and polymicrobial in 27% of cases.
Portal vein thrombosis, incidental PM finding. Portal vein thrombosis (PVT) is a vascular disease of the liver that occurs when a blood clot occurs in the hepatic portal vein, which can lead to increased pressure in the portal vein system and reduced blood supply to the liver. The mortality rate is approximately 1 in 10. [1]
Produces abdominal collateral veins to bypass the blocked inferior vena cava and permit venous return from the legs. Determine the direction of flow in the veins below the umbilicus. After pushing down on the prominent vein, blood will: flow toward the legs → caput medusae; flow toward the head → inferior vena cava obstruction.