Portal hypertension: symptoms, causes and diagnosis

Under portal hypertension, medicine implies a high blood pressure syndrome in the portal vein system, which was a consequence of impaired blood flow in the portal vessels, inferior vena cava and hepatic veins.

As a rule, this disease provokes an increase in the spleen( splenomegaly), ascites, varicose expansion of the gastric and esophageal veins, hepatic encephalopathy, or insufficiency.

Normal for the portal vein system is a pressure of 5 -10 mm. Art. If there is an excess of pressure at least by 2 mmot this mark, it is already possible to judge the onset of the development of portal hypertension. If the indicator is exceeded 12 mm. Art.varicose veins occur.

To portal hypertension lead structural pathology of blood vessels of the liver, cirrhosis and schistosomiasis.

If the pressure in the small hepatic vein is 12 mm. Art.or higher, then there is a collateral circulation between the systemic network of veins and the portal system. Collaterals appear, as a rule, in places with a close arrangement of branches of the systemic venous and portal network( mucous membranes of the stomach, esophagus, rectum or in the anterior abdominal wall).

Approximately 1 percent of the total population is prone to portal hypertension.

Basic information of

The cause of portal hypertension causes may be as follows.

• Cirrhosis of the liver.
• Education in the veins of blood clots.
• Blocking veins that carry blood from the liver to the heart.
• Parasitic infections.

However, it sometimes happens that the cause of the disease remains unknown.

Cirrhosis is the main cause of portal hypertension. Hepatitis and bad habits cause fibrotic changes in the hepatic tissue, which is the source of cirrhosis. With cirrhosis, the fibrous tissue of the blood stream is blocked by the liver.

Early signs of portal hypertension are manifested by encephalopathy, resulting in a patient experiencing a clouding of consciousness or memory impairment resulting from abnormal liver function.

In case of portal hypertension, the symptoms also appear in this way.

• Gastrointestinal bleeding leads to vomiting and staining of defecation products in black.
• In the abdominal cavity fluid accumulates, leading to ascites.
• In a laboratory blood test, the content of white blood cells is detected in a reduced amount. In this case, platelets provoke the formation of blood clots, and leukocytes resist infection.

It must be remembered that the resulting portal hypertension symptoms do not always manifest. Anxiety should be beaten when any liver disease leading to cirrhosis is diagnosed. Such patients constitute a risk group.

Etiology and pathogenesis of portal hypertension

In the case of portal hypertension, the etiology is as follows.

1. Cirrhosis of the liver is the first principle in 80% of cases.
2. All kinds of diseases of the pancreatic-biliary organs( parasitic, post-traumatic, inflammatory and tumor).
3. Congenital and acquired pathology of the hepatic vessels and inferior vena cava.
4. Migratory processes of omphalitis or consequences of umbilical vein catheterization.

Portal hypertension - the pathogenesis of it is directly related to the factors of etiology and anatomy of the venous system.

A thorough study of the anatomy of the human venous system and the portal vein system;the structure of the venous walls of various organs - the sources of venous blood for the portal vein system and the permissible level of venous pressure in it;effects of erosion-provoking factors with the severance of varicose veins;the degree of compensation for hepatic insufficiency by the Child-Pugh method and the degree of adaptive mechanisms of human organs and systems constitute the necessary foundation in the study of the problem of portal hypertension. Also, the knowledge of the portal anastomoses connecting the portal vein and its tributaries with the system of hollow veins is also of great importance in solving this problem.

Diagnosis of the disease

In case of disease, portal hypertension diagnosis begins with the establishment of a clinical picture based on patient complaints and specific symptoms expressed by various pathological syndromes. Further possible factors of the disease development are investigated. Based on the data of objective research and examination of the patient, a complete picture of the disease is drawn up in each specific case.

Instrumental diagnostic methods:

• ultrasound
• dopplerography
• X-ray examination
• endoscopy
• splenoportography
• computed tomography
• upper / lower cusp
• laboratory diagnostics.

Children's portal hypertension

Portal hypertension in children is represented by extrahepatic form. Most often, it is caused by a cavernous transformation in the development of the portal vein. Not the least role is played here and thrombosis of blood vessels, which is a consequence of umbilical vein thrombophlebitis during its catheterization in the period of newborn.

The causes of portal hypertension in children are congenital or acquired liver diseases of a diffuse nature: fetal and viral forms of hepatitis, cholangiopathy of infants with different levels of biliary tract infection and others.

The pronounced periductular fibrosis, a satellite of the above processes, contributes to the active development of pediatric portal hypertension. Splenomegaly with symptoms of hypersplenism is the main sign of extrahepatic form of portal hypertension in childhood.