Portal Hypertension

Portal hypertension is a condition in which the blood pressure in the portal vein is increased. The portal vein is the main vein of the liver, which collects blood from the spleen, pancreas, and intestine. The increase in portal vein pressure can lead to serious complications, including bleeding from veins in the esophagus and stomach. This condition can also lead to the formation of abnormal vessels called varices. Portal hypertension is usually caused by cirrhosis of the liver.

Causes of Portal Hypertension

The most common cause of portal hypertension is cirrhosis of the liver, which is the formation of scar tissue due to prolonged alcohol use or chronic viral hepatitis. Other causes of portal hypertension include:

Blockage of the portal vein.
Infection of the portal vein.
Thrombosis of the portal vein.
Cancer in the liver.
Injury to the liver.
Genetic disorders.

Symptoms of Portal Hypertension

The symptoms of portal hypertension can vary depending on the underlying cause. Common symptoms may include:

Abdominal pain.
Nausea and vomiting.
Abdominal swelling.
Fatigue.
Loss of appetite.
Weight loss.
Itching.
Yellowing of the skin (jaundice).
Bleeding from the gastrointestinal (GI) tract.
Fever.

Diagnosis of Portal Hypertension

A doctor will perform a physical examination and review your medical history. Tests and procedures used to diagnose portal hypertension include:

Blood tests.
Imaging tests, such as CT scans and ultrasounds.
Liver biopsy.
Upper endoscopy.
Doppler ultrasound.
Portography.
Liver angiography.

Treatment for Portal Hypertension

The goal of treatment for portal hypertension is to reduce the pressure in the portal vein and prevent serious complications. Treatment for portal hypertension may include:

Medications, such as beta-blockers or nitrates.
Endoscopic procedures, such as balloon tamponade or variceal band ligation.
Surgery, such as transjugular intrahepatic portosystemic shunt (TIPS) or portacaval shunt.

Outlook

Portal hypertension is a serious condition that can be life-threatening. Prompt treatment can help reduce the risk of complications. With proper medical care and lifestyle changes, such as abstaining from alcohol, most people with portal hypertension can reduce the risk of complications and live productive lives.