Portal Hypertension: From 3 Different Sources
Increased blood pressure in the portal vein, which carries blood from the stomach, intestine, and spleen to the liver. This causes oesophageal varices, which may rupture and cause internal bleeding, and ascites. The most common cause of portal hypertension is cirrhosis.
Diagnosis is usually made from the symptoms and signs.
Doppler ultrasound scanning may be used to assess the pressure in the portal vein.
Various treatments may be used to stop bleeding or prevent further bleeding.
For example, ruptured blood vessels may be treated by sclerotherapy, in which a chemical is injected into the veins to block them.
A shunt is sometimes carried out to prevent further bleeding.
Ascites is controlled by restriction of salt and with diuretic drugs.
Raised blood pressure in the PORTAL VEIN entering the LIVER. This results in increased pressure in the veins of the oesophagus and upper stomach and these grow in size to form varices – dilated tortuous veins. Sometimes these varices rupture, causing bleeding into the oesophagus. The raised pressure also causes ?uid to collect in the abdomen and form ASCITES. The commonest reason for portal hypertension is cirrhosis (?brosis) of the liver (see LIVER, DISEASES OF). THROMBOSIS in the portal vein may also be a cause. Treatment requires the cause to be tackled, but bleeding from ruptured vessels may be stopped by injecting a sclerosant or hardening solution into and around the veins. Sometimes a surgical shunt may be done to divert blood from the portal vein to another blood vessel.
a state in which the pressure within the hepatic *portal vein is increased, causing enlargement of the spleen, development of *oesophageal varices (with increased risk of bleeding), and accumulation of fluid in the peritoneal cavity (*ascites). The commonest cause is liver *cirrhosis, but other diseases of the liver or thrombosis of the portal vein may precipitate portal hypertension. Treatment includes *diuretics, band ligation or beta blockers for varices, and transjugular intrahepatic portosystemic shunt (TIPSS). This involves the radiological implantation of a stent that bridges the portal and hepatic veins, thus decompressing the portal system. TIPSS has largely replaced *portacaval anastomosis.
High arterial blood pressure... hypertension
In this condition, increased resistance to the blood ?ow through the LUNGS occurs. This is usually the result of lung disease, and the consequence is an increase in pulmonary artery pressure and in the pressure in the right side of the heart and in the veins bringing blood to the heart. Chronic BRONCHITIS or EMPHYSEMA commonly constrict the small arteries in the lungs, thus causing pulmonary HYPERTENSION. (See also EISENMENGER SYNDROME.)... pulmonary hypertension
Malignant hypertension has nothing to do with cancer; it derives its name from the fact that, if untreated, it runs a rapidly fatal course. (See HYPERTENSION.)... malignant hypertension
A vein or collection of veins which ?nish at both ends in a bed of capillary blood vessels. An important example is the hepatic portal system, comprising the portal vein and its tributaries. Blood from the stomach, pancreas, spleen and intestines drains into the veins that join up to comprise the portal vein into the liver, where it branches into sinusoids.... portal system
See HYPERTENSION.... essential (benign) hypertension
This is a type of circulatory bypass used when substances in blood or fluid need to be kept out of the general flow. A portal system begins in capillaries and ends in capillaries, and nothing leaves it undocumented. The hypothalamus sends hormones into the portal system between it and the pituitary, and the pituitary responds to it by secreting its own hormones, but dissolving the hypothalamus ones. Blood that leaves the intestinal tract, spleen, and pancreas (partially) goes into the liver’s portal system and does not leave that organ until it has been thoroughly screened and altered.... portal circulation
see idiopathic intracranial hypertension.... benign intracranial hypertension
(benign intracranial hypertension, pseudotumour cerebri) a syndrome of raised pressure within the skull in the absence of a clear structural cause, such as a tumour. Although the cause is not certain, proposed mechanisms include impaired reabsorption of cerebrospinal fluid or venous outflow from the brain. The symptoms include headache, vomiting, double vision, and *papilloedema. The diagnosis is made by finding a high opening pressure at *lumbar puncture in the absence of a causative structural abnormality on brain imaging. It can improve spontaneously but drug therapy or neurosurgical treatment may be required to protect the patient’s vision.... idiopathic intracranial hypertension
(OHT) a constantly raised intraocular pressure (greater than 21 mmHg by Goldmann applanation *tonometry) registered on two or more occasions in one or both eyes with the absence of evidence of optic nerve damage or visual field defect. Intraocular pressure increases slowly with age and OHT can increase the risk of developing glaucoma. It is treated with eye drops and surgery if indicated.... ocular hypertension
adj. 1. relating to the portal vein or system. 2. relating to a porta.... portal
an electronic image taken during radiotherapy treatment to verify the position of radiation beams.... portal image
(PIH) raised blood pressure (>140/90 mmHg) developing in a woman during the second half of pregnancy. It usually resolves within six weeks of delivery and is associated with a better prognosis than *pre-eclampsia.... pregnancy-induced hypertension
disease affecting the arterial supply to the kidneys, leading to ischaemia and resultant stimulation of the renin-*angiotensin-aldosterone axis. In the major vessels, the most common cause is atheromatous plaque disease. Other causes are fibromuscular dysplasia and *Takayasu’s disease.... renovascular hypertension
Health Encyclopedia