Definition
Portal hypertension is defined as the elevation of
hepatic venous pressure greadient to>5mmHg
Clinically significant portal hypertension
HVPG>10mmHg
of 12mmHg
Classification
PRE-HEPATIC
portal vein thrombosis
massive splenomegaly
Classification..
HEPATC
? 1.Pre sinusoidal
congenital hepatic fibrisis
2.Sinusoidal
cirrhosis
alcoholic hepatitis
hepatic sinusoidal obstruction
Classification...
POST-HEPATIC
Budd-Chiari syndrome
cardiac causes:
restrictive cardiomyopathy
constrictive pericarditis
severe congestive heart failure
Pathophysiology
The fundamental haemodynamic abnormality is
increased resistance to portal blood flow
Results in development of collateral circulation that
diverts obstructed bloodflow to systemic veins
Clinical features
Ascitis
Increased portosystemic shunt
oesophageal varices
haemorrhoids
Hypersplenism
Hepatic encephalopathy
Hepatorenal failure
Thank you..
Portal hypertension is defined as the elevation of
hepatic venous pressure greadient to>5mmHg
Clinically significant portal hypertension
HVPG>10mmHg
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Risk of variceal bleeding increases beyond a gradientof 12mmHg
Classification
PRE-HEPATIC
portal vein thrombosis
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splenic vein thrombosismassive splenomegaly
Classification..
HEPATC
? 1.Pre sinusoidal
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schistisomiasiscongenital hepatic fibrisis
2.Sinusoidal
cirrhosis
alcoholic hepatitis
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3.Post sinusoidalhepatic sinusoidal obstruction
Classification...
POST-HEPATIC
Budd-Chiari syndrome
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Inferior venacaval webscardiac causes:
restrictive cardiomyopathy
constrictive pericarditis
severe congestive heart failure
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Pathophysiology
The fundamental haemodynamic abnormality is
increased resistance to portal blood flow
Results in development of collateral circulation that
diverts obstructed bloodflow to systemic veins
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Clinical features
Ascitis
Increased portosystemic shunt
oesophageal varices
haemorrhoids
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caput medusaeHypersplenism
Hepatic encephalopathy
Hepatorenal failure
Thank you..
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