Download MBBS Portal Hypertension Lecture PPT

Definition
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 gradient
of 12mmHg

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Classification
PRE-HEPATIC
portal vein thrombosis

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splenic vein thrombosis
massive splenomegaly

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Classification..
HEPATC
? 1.Pre sinusoidal

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schistisomiasis
congenital hepatic fibrisis
2.Sinusoidal
cirrhosis
alcoholic hepatitis

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3.Post sinusoidal
hepatic sinusoidal obstruction

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Classification...
POST-HEPATIC
Budd-Chiari syndrome

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Inferior venacaval webs
cardiac 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 medusae
Hypersplenism
Hepatic encephalopathy
Hepatorenal failure

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Thank you..

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