Portal Hypertension

Portal hypertension is a condition where there is increased blood pressure within the large vein that carries blood from the digestive organs to the liver, called the portal vein. This happens when blood flow through the liver is blocked or slowed down, often due to liver damage. The increased pressure causes blood to find alternative pathways, which can lead to swollen veins called varices in the esophagus or stomach. These varices can rupture and cause serious bleeding. Other effects include fluid buildup in the abdomen, known as ascites, and enlargement of the spleen. The condition mainly affects the circulatory system and the liver, impacting digestion and blood flow.

Portal hypertension is defined as an abnormal elevation of pressure within the portal venous system, typically exceeding 10 mmHg, caused by increased resistance to portal blood flow. The most common cause is cirrhosis, which leads to fibrosis and architectural distortion of the liver, increasing intrahepatic vascular resistance. Other causes include portal vein thrombosis and schistosomiasis. The elevated pressure results in the development of portosystemic collaterals, including esophageal and gastric varices, which pose a risk for life-threatening hemorrhage. Clinical manifestations include ascites, splenomegaly, and hepatic encephalopathy due to shunting of blood away from the liver. Diagnosis and management focus on preventing complications related to increased portal pressure.