Portal hypertension - Medtick

Portal hypertension

What is it?

Portal hypertension is a condition caused by liver disease.

  • The liver receives blood from two sources.
    • Fresh blood, coming from the heart, supplies the needs of the liver itself.  because the liver filters toxins and processes nutrients.
    • Blood from the intestines, stomach , pancreas and other organs of the digestive system comes in via the portal vein. The blood in the portal vein flows directly into the liver and is able to interact with the hepatocytes (liver cells). The blood continues through the liver and returns to the heart and lungs through a different set of vessels, the hepatic veins.

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  • Portal hypertension is when there is some sort of obstruction and/or poor and/or slow blood flow in the  portal veins leading from the intestines to the liver.
  • It’s a significant complication of alcoholic hepatitis (inflammation and scarring of the liver due to high consumption of alcohol)  and liver cirrhosis (scarring to the point if affects the blood supply to the liver causing a loss of function).

This condition can lead to:

Ascites

  • An increased or high level of fluid collection within the peritoneum (the sac that contains the intestines within the abdominal cavity- the outside lining of the organs- this space has peritoneal fluid which helps to reduce friction between the belly and the organs during digestion).
  • It is due to a combination of factors, including increased pressure in the portal system and decrease protein in the body which the liver produces, this causes fluid to leak out of the portal vein and into the abdominal cavity and lining – the peritoneum.
  • The blood volume is reduced and the kidney then responds and try to retain salt and water in the body, this causes further swelling.
  • Ascites can also be caused by cancer, heart failure, kidney failure, inflammation of the pancreas (pancreatitis), and tuberculosis affecting the lining of the abdomen.
  • Symptoms include:
    • Increased abdominal swelling and belly size
    • Ankle swelling
    • Shortness of breath
    • Feeling full after eating small amounts of food
    • Appetite loss

Varices

  • Described as  enlarged veins. Blood that is meant for the portal system, is diverted to and gathers in other veins as it makes its way to the heart these include along the oesophagus, stomach, intestines, rectum and/or anus.
  • This can put pressure on blood vessels and they can rupture and bleed.
Anyone with the above condition and bleeds from any orifice must seek urgent medical attention

Cause

Syndromes

Medication i.e.

  • methotrexate

Symptoms

  • Easily bruised and/or unexplained bruising (purpura)?
  • Cold sores and/or Pinpoint red spots on the skin?
  • Prolonged bleeding from small cuts?
  • Nose bleeds?
  • Bleeding gums?
  • Joint pain and stiffness?
  • Pain, numbness, burning and tingling (pins and needles) sensation in one’s hands and fingers (thumb and/or index finger and/or middle finger and/or ring finger and/or small finger)?
  • Tingling sensation in one or both legs?
  • Inflamed (hot, red and swollen) joints, tenderness and warmth to the touch
  • Enlarged spleen?
  • Encephalitis (liver can’t remove toxins from the blood and hence it travels to the brain)?

    Complications /Information to beware of/General tips:

    Medical Emergency Condition

    And/or do not wait, phone for ambulance if have or develop:

    • Aneurysm
    • Peritonitis
    • If have liver disease/condition and have swelling in the abdominal region
    • If have Hepatitis and have swelling in the abdominal region
    • Shortness of breath and/or breathing difficulties?
    • Bleeding from any orifice i.e. Black tarry stools, coughing up blood:
      • Esophageal varices develop when normal blood flow to the liver is blocked by a clot or scar tissue in the liver.
      • To go around the blockages, blood flows into smaller blood vessels that aren’t designed to carry large volumes of blood.
      • The vessels can leak blood or even rupture, causing life-threatening bleeding.
    • Shock:
      • Rapid heart rate (rapid pulse)
      • Rapid breathing
      • Dilated pupils
      • Pale, cool skin
      • Sweating (diaphoresis)
      • Yawning
    • If shock occurs (whilst awaiting for an ambulance):
      • Lay the person down (if their injuries allow it) and raise and support their legs
      • Use a coat or blanket to keep them warm, but do not cover their face or the burnt area
      • Do not give them anything to eat or drink

    This condition can cause the symptom:


    This condition can lead to:

    Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

    Detailed Information

    Please copy and paste any key words from the title: Portal hypertension in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

    • NHS

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