Gastroenterology Book

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Portal Hypertension

Aka: Portal Hypertension, Hepatic Vein Pressure Gradient, HPVG
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  1. See Also
    1. Cirrhosis
    2. Esophageal Varices
  2. Pathophysiology: Cirrhosis-Related Varices
    1. Liver disease (Cirrhosis) results in scarring
    2. Scarring narrows and compresses hepatic sinusoids
      1. Results in resistance to flow
      2. Increases portal pressure
    3. Portal pressure increases over critical threshold
      1. Portal-systemic venous pressure gradient >12 mmHg
    4. Vessels form at portal-systemic junctures
      1. Distal Esophagus
      2. Stomach
    5. Existing vessels dilate
      1. Secondary dilation of left gastric vein
      2. Esophageal Varices develop
  3. Causes: Portal vein Hypertension
    1. Extrahepatic Causes (Portal VeinOcclusion)
      1. Umbilical vein infection
      2. Trauma
      3. Chronic Pancreatitis
      4. Polycythemia Vera
      5. Pro-thrombotic conditions
    2. Hepatic Causes
      1. Liver malignancy involving sinusoids
      2. Amyloidosis involving liver
      3. Fatty Liver
  4. Associated Conditions
    1. Hypersplenism
    2. Esophageal Varices
  5. Diagnosis
    1. Hepatic Vein Pressure Gradient (HPVG)
      1. Measured with hepatic vein catheterization
      2. Free hepatic vein pressure - hepatic vein wedge
      3. HPVG >5 mmHg is Portal Hypertension
      4. HPVG >10 mmHg is significant Portal Hypertension
    2. Upper endoscopy
      1. Esophageal size predicts HPVG
  6. Management
    1. Goal is to lower risk of Bleeding Esophageal Varices
    2. See Esophageal Varices for Management
  7. References
    1. Trevillyan (1997) Am Fam Physician 55(5):1851-1862

Hypertension, Portal (C0020541)

Definition (NCI) Increased blood pressure in the portal venous system. It is most commonly caused by cirrhosis. Other causes include portal vein thrombosis, Budd-Chiari syndrome, and right heart failure. Complications include ascites, esophageal varices, encephalopathy, and splenomegaly.
Definition (NCI) A disorder characterized by an increase in blood pressure in the portal venous system.
Definition (NCI) High blood pressure in the vein that carries blood to the liver from the stomach, small and large intestines, spleen, pancreas, and gallbladder. It is usually caused by a block in the blood flow through the liver due to cirrhosis (scarring) of the liver.
Definition (MSH) Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN.
Definition (CSP) abnormally increased pressure in the portal venous system, frequently seen in cirrhosis of the liver and other conditions causing obstruction of the portal vein.
Concepts Disease or Syndrome (T047)
MSH D006975
ICD9 572.3
ICD10 K76.6
SnomedCT 155821005, 34742003
English Hypertension, Portal, Hypertensions, Portal, Portal Hypertensions, HYPERTENSION PORTAL, HYPERTENSION, PORTAL, PORTAL HYPERTENSION, Portal hypertension syndrome, portal hypertension (diagnosis), portal hypertension, Hypertension portal, Hypertension, Portal [Disease/Finding], hypertension portal, Hypertension;portal, Portal hypertensions, Portal hypertension, PHT - Portal hypertension, Portal hypertension (disorder), hypertension; portal, portal; hypertension, Portal Hypertension
French HYPERTENSION PORTALE, Hypertensions portales, Hypertension portale
Portuguese HIPERTENSAO PORTAL, Hipertensão portal, Hipertensões portais, Hipertensão Portal
Spanish HIPERTENSION PORTAL, Portal hypertension, hipertensión portal (trastorno), hipertensión portal, Hipertensión de la vena porta, Hipertensión portal, Hipertensión Portal, Hipertension Portal
Italian Ipertensioni della portale, Ipertensione della portale, Ipertensione portale
German Hypertonie portal, PFORTADERHOCHDRUCK, Portale Hypertonie, Portale Hypertonien, portale Hypertonie, Hypertonie, portale
Swedish Hypertoni, portal
Japanese ﾓﾝﾐｬｸｱﾂｺｳｼﾝｼｮｳ, ﾓﾝﾐｬｸｺｳｼﾝ, 圧亢進症-門脈, 門脈うっ血, クリュベリエ-バウムガルテン症候群, 門脈圧亢進, 門脈高血圧症, クリュベリエ･バウムガルテン症候群, 高圧症-門脈, 門脈高圧症, Cruveilhier-Baumgarten症候群, 門脈圧亢進症
Czech hypertenze portální, Hypertenze portální, Portální hypertenze
Finnish Portahypertensio
Russian KRIUVEL'E-BAUMGARTENA TSIRROZ, GIPERTENZIIA PORTAL'NAIA, KRIUVEL'E-BAUMGARTENA SINDROM, ГИПЕРТЕНЗИЯ ПОРТАЛЬНАЯ, КРЮВЕЛЬЕ-БАУМГАРТЕНА СИНДРОМ, КРЮВЕЛЬЕ-БАУМГАРТЕНА ЦИРРОЗ
Korean 문맥고혈압
Croatian HIPERTENZIJA, PORTALNA
Polish Nadciśnienie wrotne, Zespół nadciśnienia wrotnego, Zespół Cruveilhier-Baumgartena
Hungarian Portalis hypertonia, Portalis hypertoniak, Portalis hypertensio
Dutch hypertensie; portaal, portaal; hypertensie, portale hypertensies, portale hypertensie, Hypertensie, portale, Portale hypertensie
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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