Portal Hypertention

Portal Hypertention is a medical condition, in which abnormally high blood pressure in the large vein, called portal vein, delivers blood from the person’s intestine to the liver. Portal Hypertention

Portal Hypertention frequently enlarges the spleen. Fluid can leak out of the person’s liver and distend the cavity of abdomen (ascites). Varicose veins in the lining of the stomach and at the lower end of person’s esophagus bleed easily and, in some cases, massively. Varicose rectum veins can also bleed, but it happens rarely. Generally, the doctor may feel an enlarged spleen through the wall of abdomen.

Abdominal fluid may be discovered by hearing a dull sounds when tapping percussing the abdomen and noting abdominal swelling. X-ray and ultrasound scans provide important information about Portal Hypertention, CT (computed tomography) scan may be used to check the enlarged veins; and ultrasound scan can be helpful to evaluate the flow of the blood in the portal blood vessel and may show the presence of abdominal fluid.

Portal system pressure can be checked directly by a needle placed through the wall of the abdomen and into the spleen or liver. To lower esophageal veins bleeding risk, gastroenterologist tries to reduce the portal vein’s pressure. The medication, called Propranolol, may be prescribed to treat high blood pressure. Esophageal varices bleeding requires prompt medical attention. Medications, including Octreotide or Vasopressin can be performed intravenously to constrict the bleeding vein, and blood transfusion is needed to replace lost blood. Endoscopic evaluation is performed to be sure that the bleeding is coming from varicose veins( esophageal varices). The veins then may be blocked off with chemical injection given through the endoscope or with rubber bands.

If the bleeding does not stop, a catheter with balloon may be inserted through the nose and down esophagus. Balloon inflating compresses the varicose vein and commonly stops the bleeding. If the bleeding still continues or reappears often, a surgical procedure can be performed to create bypass (shunt) between systemic (general) venous system and portal venous system. Such procedure reduce the portal vein pressure, because the pressure is significantly lower in the general (systemic) venous system.  There are many different kinds of portal general bypass operations; for example, one may be performed under x-rays guidance in radiology unit by using specific instruments. Shunt (bypass) operation is generally successful in stopping the person’s bleeding, but it is considerably dangerous. Shunt (bypass) operation may increase the brain’s dysfunction risk from liver encephalopathy (liver failure).

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