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The causes for portal hypertension are classified as originating in the portal venous system before it reaches the liver (prehepatic causes), within the liver (intrahepatic) or between the liver and the heart (post-hepatic). The most common cause is cirrhosis (chronic liver failure).
Portal hypertension, an important consequence of liver disease, results in the development of significant collateral circulation between the portal system and systemic venous drainage (porto-caval circulation). Portal venous congestion causes venous blood leaving the stomach and intestines to be diverted along auxiliary routes of lesser ...
Portal hypertension is a condition in which the blood pressure of the portal venous system is too high. It is often the result of cirrhosis of the liver. Liver cirrhosis can lead to increased intrahepatic vascular resistance and vasodilation of portal system arteries, both of which increase pressure in the portal vein. [4]
Transjugular intrahepatic portosystemic shunt procedures, or TIPS involve decompressing the portal vein by shunting a portal venule to a lower pressure systemic venule, under guidance with fluoroscopy. Since it treats the root cause of portal hypertension gastropathy, it has been putatively used for the condition.
Portal venous pressure is the blood pressure in the hepatic portal vein, and is normally between 5-10 mmHg. [1] Raised portal venous pressure is termed portal hypertension , [ 2 ] and has numerous sequelae such as ascites and hepatic encephalopathy .
Portal hypertension is commonly seen with liver cirrhosis and/or other liver diseases such as Budd–Chiari syndrome, primary biliary cirrhosis (PBC), and portal vein thrombosis. [2] The purpose of the shunt is to divert blood flow away from the liver, reducing the high pressure in the portal venous system and decreasing the risk of bleeding. [3]
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%. [8] On Doppler ultrasonography, the main portal vein (MPV) peak systolic velocity normally ranges between 20 cm/s and 40 cm/s. [9]
Portal hypertension may be present, resulting in other conditions including enlarged spleen, hematemesis, and melena. [6] These problems can severely affect the patient's quality of life. In a 10-year period between 1995 and 2005, only 10 patients were surgically treated for Caroli disease, with an average patient age of 45.8 years.