Diseases
Portal hypertension-causes, symptoms, diagnosis, treatment.
Portal hypertension-causes, symptoms, diagnosis, treatment.
Portal hypertension, which
means: increasing in the pressure within the portal vein and its branches which
is the vein that carries blood from digestive organs to the liver; and because
it is a vein, the blood pressure should be 5:10 mmHg. If the blood pressure is higher
than 12 mmHg, which is portal hypertension.
In this article:
·
The causes of portal hypertension.
·
The symptoms of portal hypertension.
·
How can portal hypertension be diagnosed?
·
The treatment.
The causes of portal hypertension:
The increase
in the blood pressure in the portal vein happens when there is an obstruction
in the passage of blood from the portal the vein to IVC that makes venous blood
accumulates downwards from obstruction, but there is another cause of portal
hypertension which is Cirrhosis when the scar tissue blocks the flow of blood
through the liver and slows its processing factors, and this is the most common
cause in western countries. Portal hypertension may happen because of
thrombosis or a blood clot that develops in the portal vein.
There are more causes of portal hypertension that is
because of infections such as:
·
Schistosomiasis, which is a parasitic infection.
· Focal nodular
hyperplasia, that is a disease seen in people infected with human
immunodeficiency virus.
·
In some cases, the cause of portal hypertension maybe
unknown.
The symptoms of portal hypertension:
·
Ascites that means an accumulation of fluid of abdomen.
·
Caput medusae
·
Diminished liver function
·
Enlarged spleen
·
Esophageal varices
·
Gastrointestinal bleeding: black, tarry stools or blood in stools; or
vomiting of blood due to the spontaneous rupture and bleeding from varices.
·
Enceophalo pathy
·
Reduced levels of platelets or decreased white blood cell count.
How can portal
hypertension be diagnosed:
·
Portal hypertension's diagnosis can be done by:
·
Endoscopic examination
·
X-ray studies
·
lab tests to confirm that there is a variceal bleeding
·
Measuring the blood pressure in the portal vein and IVC by inserting aa catheter that measures blood pressure.
The treatment:
To treat portal hypertension, the blood pressure should be decreased; so first of all: changing the lifestyle is very important and it will be done by:
·
Improving diet and eating healthy food
·
Avoiding alcohol consumption
·
Exercising regularly
·
Quitting smoking
·
Following a low-sodium diet
The second path in the treatment is medications such as:
·
Beta-blockers or nitrates
·
Using propranolol and Isosorbide that helping in:
1. Lower the pressure in the portal vein.
2. Reducing the risk of more internal bleeding.
·
The doctor may advise using diuretics for ascites.
·
The drug lactulose that has the ability to increase the bowel movements.
The third way or path in the
treatment is endoscopic therapy that done by Scelotherapy which is: making
placement or rubber bands to block unhealthy blood flow to enlarged veins that are
known as varices.
If the previous ways of treatment do not successfully control the variceal bleeding, it may require one of the following decompression procedures to reduce the pressure in these veins:
1.
TIPS and this means:
Transjugular Intrahepatic
Portal-systemic Shunt
This therapy helps control
acute bleeding by creating new pathways for blood to flow from the portal vein
to other blood vessels
2.
2- DSRS which means:
Distal splenorenal shunt
It is a surgical procedure that connects the
splenic vein to the left kidney vein in order to reduce pressure in the varices
and control bleeding.
If a TIPS or a DSRS can't be
done or is unsuccessful in controlling the bleeding there is another surgical
procedure which is: Devascularization that removes the bleeding varices.
In cases of end-stage liver
disease, surgeries may need to make a liver transplant to the patient.
Ascites, which are an accumulation of fluid in
the abdomen, sometimes need to be directly removed by a procedure called
paracentesis.
Written by:
Ganna Ahmed Ellabany
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