In medicine, portal hypertension is hypertension (high blood pressure) in the portal vein and its branches. It is often defined as a portal pressure gradient (the difference in pressure between the portal vein and the hepatic veins) of 12 mm Hg or greater. Many conditions can result in portal hypertension, but it is usually the result of cirrhosis of the liver. The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Medicine is the branch of health science and the sector of public life concerned with maintaining human health or restoring it through the treatment of disease and injury. ... For other forms of hypertension see hypertension (disambiguation) Hypertension or high blood pressure is a medical condition wherein the blood pressure is chronically elevated. ... The portal vein is a major vein in the human body draining blood from the digestive system and its associated glands. ... Cirrhosis is a chronic disease of the liver in which liver tissue is replaced by connective tissue, resulting in the loss of liver function. ... The liver is the largest internal organ of the human body. ...

Signs and symptoms

Consequences of portal hypertension are caused by blood being forced down alternate channels by the increased resistance to flow through the portal system. They include:

• Ascites (free fluid in the peritoneal cavity)
• Esophageal varices (dilated veins in the wall of the esophagus that are prone to bleed)
• Rectal varices
• Hepatic encephalopathy
• Palmar erythema
• Clubbing
• Distended abdominal wall veins (caput medusae)
• Increased risk of spontaneous bacterial peritonitis
• Increased risk of hepatorenal syndrome

In higher vertebrates, the peritoneum is the membrane that forms the lining of the abdominal cavity - it covers most of the intra-abdominal organs. ... In medicine (gastroenterology), esophageal varices are extreme dilations of sub mucosal veins in the mucosa of the esophagus in diseases featuring portal hypertension, secondary to cirrhosis primarily. ... The esophagus (also spelled oesophagus/Å“sophagus), or gullet is the muscular tube in vertebrates through which ingested food passes from the mouth area to the stomach. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... Hepatic encephalopathy is a condition (usually caused by liver cirrhosis and its resultant portal hypertension) where brain cells are damaged by a build-up of toxic substances in the blood. ... Palmar erythema is reddening of the palms at the thenar and hypothenar eminences. ... In medicine, clubbing (or digital clubbing) is a deformity of the fingers and fingernails that is associated with a number of diseases, mostly of the heart and lungs. ... Caput medusae means dilated veins around the umbilicus. ... Spontaneous bacterial peritonitis is a form of peritonitis that occurs in patients with cirrhosis. ... Hepatorenal syndrome (HRS) is liver failure that results in concomitant renal failure. ...

Treatment

Medical management

Treatment with a non-selective beta blocker is generally commenced once portal hypertension has been diagnosed, typically with propranolol. In acute or severe complications of the hypertension, such as bleeding varices, intravenous terlipressin (an antidiuretic hormone analogue) is commenced to decrease the portal pressure. Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... // Pharmacology and Indications Propranolol (Inderal®) is a non-selective beta blocker (i. ... Terlipressin as vasoactive drug used for the management of hypotension. ... Antidiuretic hormone (ADH), or arginine vasopressin (AVP), is a peptide hormone produced by the hypothalamus, and stored in the posterior part of the pituitary gland. ...

Percutaneous interventions

Transjugular intrahepatic portosystemic shunting is the creation of a connection between the portal and the venous system. As the pressure over the venous system is lower than over a hypertensive portal system, this would decrease the pressure over the portal system and a decreased risk of complications. This page is a candidate for speedy deletion. ...

Surgical interventions

• Distal splenorenal shunt
• Liver transplant

The most definitive treatment of portal hypertension is a liver transplant. In medicine, a distal splenorenal shunt procedure (DSRS), also splenorenal shunt procedure and Warren shunt,[1] is a surgical procedure in which the distal splenic vein (a part of the portal venous system) is attached to the left renal vein (a part of the systemic venous system). ...

External links

• Merck
• eMedicine
• Cleveland Clinic