Diagnosis portal vein hypertension
For the detection of portal vein hypertension, it is not possible to use the definition directly, since it is not possible to measure blood pressure locally in the portal vein. Instead, the diagnosis is made on the basis of various other criteria. These include the detection of bleeding in the esophagus (esophageal varices) during an endoscopy, the detection of a blood flow slowdown in the portal vein by ultrasound, the thickening of the spleen (splenomegaly) also by ultrasound, or the presence of free fluid in the abdominal cavity (ascites). In addition, efforts are also made to detect the disease causing high pressure in the portal vein (cirrhosis of the liver, thrombosis), as it is essential to treat this as well.
Therapy portal vein hypertension
First of all, the reason for portal vein hypertension must be found, since a purely symptomatic therapy can only help in the short term. Depending on the trigger of the underlying disease, the consumption of alcohol must be stopped immediately, the thrombus must be dissolved, etc. The bleeding from the esophagus must be stopped acutely by means of an endoscope and the administration of haemostatic drugs.
In the long term, one tries to reduce the increased pressure in the portal vein with the help of antihypertensive tablets (beta-blockers). The accumulation of free fluid in the abdominal cavity is initially treated with rather unspecific measures such as reduced fluid intake, administration of drainage tablets (diuretics) and limitation of salt intake. As a further measure, the fluid can also be removed with a syringe (puncture, therapeutic paracentesis).
