Portal Hypertension: Causes, Symptoms, Daignosis, Prevention and Treatment - PowerPoint PPT Presentation

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Portal Hypertension: Causes, Symptoms, Daignosis, Prevention and Treatment

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Portal Hypertension is high blood pressure which is caused in the portal vein, the blood vessel that connects the intestines and the liver. – PowerPoint PPT presentation

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Title: Portal Hypertension: Causes, Symptoms, Daignosis, Prevention and Treatment


1
Portal Hypertension
2
Portal Hypertension
  • Portal hypertension is high blood pressure which
    is caused in the portal vein, the blood vessel
    that connects the intestines and the liver.
    Generally, the condition develops in people who
    have liver damage.The scar tissues that are
    present in the liver obstruct normal blood flow
    further causing blood to back up into the portal
    vein and increasing blood pressure.Further this
    backup causes the blood to force its way into
    small, thin-walled veins at the base of the
    esophagus and within the stomach. These blood
    vessels that are known as varices gets stretched,
    swollen, and twisted and are in danger of
    breaking and bleeding.

3
Causes and Risk Factors
  • People who are having portal hypertension also
    have a damaged liver. The causes of a damaged
    liver include 
  • Cirrhosis
  • Chronic viral hepatitis
  • Blood clots
  • Various congenital disorders and
  • Primary biliary cirrhosis, an autoimmune disease.

4
Diagnosis of Portal Hypertension
  • Portal hypertension is suspected if a person
    with liver disease also has ascites, varices, or
    encephalopathy.To confirm the diagnosis of
    portal hypertension, a doctor may order one or
    more of the following tests
  • Computed tomography (CT) scan
  • Ultrasound or
  • Endoscopy (physicians insert a viewing tube
    called an endoscope through the mouth and down
    into the beginning of the small intestine).

5
What are the symptoms of Portal Hypertension?
  • By itself, portal hypertension has no symptoms.
    The mentioned below are some complications of
    portal hypertension, however, cause symptoms
    Causes 
  • Bloody vomiting, and
  • Black, loose stools.The settlement of fluid in
    the abdomen (ascites) happens when a liver
    becomes so damaged that it can no longer make the
    protein albumin, which holds fluid inside blood
    vessels.When the brain comes in contact with
    toxins like ammonia that a damaged liver cannot
    clear from the body, a brain disease called
    encephalopathy results.

6
What are the symptoms of Portal Hypertension?
Continue
  • Some signs of encephalopathy include 
  • Neglect of personal appearance
  • Unresponsiveness
  • Forgetfulness
  • Difficulty in concentrating
  • Confusion and
  • Coma.

7
Treatment Approach
  • Treatment for portal hypertension begins when
    varices bleed majorly. Patients who experience
    this issue will receive the following
  • Intravenous fluids
  • Blood transfusions and
  • Emergency endoscopy to confirm the source of the
    bleeding.
  • Once the bleeding is located, doctors use one of
    the following endoscopic techniques to extract
    the varices 
  • Sclerotherapy
  • Latex banding or
  • Balloon tamponade.

8
Treatment Approach
Continue
  • Along with these endoscopic therapies, patients
    receive intravenous blood pressure-lowering
    medications, like 
  • Beta-blockers
  • Long-acting nitrates
  • Vasoconstrictors or
  • Vasodilators.
  • When endoscopic treatments are unable to cure
    varices effectively, doctors can place a stent,
    or a thin mesh-metal tube, to reroute blood and
    relieve pressure on the portal vein.

9
Treatment Approach
Continue
  • To treat ascites, doctors recommend lifestyle
    changes and over-the-counter treatments, like 
  • Avoiding alcohol
  • Eating a low-sodium diet and
  • Taking diuretics to remove fluid from the body.
    If the abdomen gets extremely swollen, doctor can
    advise to have paracentesis (the insertion of a
    catheter into the abdominal wall to drain excess
    fluid.)
  • To treat encephalopathy, a doctor may suggest
    one or more of the following 
  • Substituting vegetable protein for animal protein
    or
  • Lactalose, laxatives and antibiotics (medications
    that extract toxins from the intestines).

10
Treatment Approach
Continue
  • Patients become candidates for a liver
    transplant when they have portal hypertension
    with variceal bleeding and end-stage liver
    disease.

11
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