Portal Hypertension

Portal Hypertension: Symptoms, Complaints, Signs

Portal hypertension (portal hypertension; portal vein hypertension) itself does not cause symptoms or discomfort, but complications can result. The following symptoms and complaints may indicate portal hypertension: Anorexia (loss of appetite). Ascites (abdominal dropsy) Caput medusae (Latin: head of Medusa) – visible expansion of tortuous veins (venae paraumbilicales) in the region of the navel as … Portal Hypertension: Symptoms, Complaints, Signs

Portal Hypertension: Causes

Pathogenesis (development of disease) The portal vein (vena portae) collects blood from the veins of the unpaired abdominal organs (gastrointestinal tract/gastrointestinal tract and spleen) and delivers it to the liver. There, among other things, the elimination of toxins takes place, most of which are metabolized (metabolized) in the liver. The most common cause of portal … Portal Hypertension: Causes

Portal Hypertension: Therapy

In addition to prophylaxis or therapy of variceal hemorrhage, treatment of the underlying disease is the primary concern. General measures Alcohol abstinence (complete abstinence from alcohol). Nicotine restriction (refrain from tobacco use) – smoking promotes fibrosis (proliferation of connective tissue fibers) of the liver. Conventional non-surgical therapy methods For acute variceal hemorrhage: Monitoring or observation … Portal Hypertension: Therapy

Portal Hypertension: Test and Diagnosis

1st-order laboratory parameters-obligatory laboratory tests. Small blood count [thrombocytopenia (platelet deficiency); anemia (anemia)] Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT) [only mildly elevated or normal], glutamate dehydrogenase (GLDH), gamma-glutamyl transferase (γ-GT, gamma-GT; GGT), alkaline phosphatase, bilirubin [bilirubin ↑] CHE (cholinesterase) [CHE ↓, as a sign of liver synthesis disorder] Coagulation parameters … Portal Hypertension: Test and Diagnosis

Portal Hypertension: Drug Therapy

Therapeutic Targets Avoidance of complications and sequelae such as esophageal variceal or fundus variceal hemorrhage. In variceal bleeding: hemostasis. Avoidance of sepsis (blood poisoning). Avoidance of recurrent bleeding (bleeding again). Therapy recommendations Reduction of portal pressure via reduction of portal-venous inflow → improved prognosis: fewer complications of portal hypertension and consequently reduced mortality (morbidity). Suitable … Portal Hypertension: Drug Therapy

Portal Hypertension: Diagnostic Tests

Mandatory medical device diagnostics. Angiography (imaging of blood vessels by contrast medium in an X-ray examination) – to visualize collateral vessels. Determination of hepatic vein pressure gradient (LVDG = difference between free hepatic vein pressure (FLVD) and hepatic vein occlusion pressure (LVVD)) – indirect measurement of portal pressure (cathetization of a hepatic vein); hepatic vein … Portal Hypertension: Diagnostic Tests

Portal Hypertension: Surgical Therapy

Acute esophageal variceal or fundal variceal hemorrhage The following measures can be considered to stop acute esophageal variceal or fundus variceal hemorrhage: Rubber band ligation (GBL) – This is performed endoscopically and is considered the method of choice. It is associated with significantly fewer complications than variceal sclerotherapy. Variceal sclerotherapy (variceal sclerotherapy) – This involves … Portal Hypertension: Surgical Therapy

Portal Hypertension: Prevention

To prevent portal hypertension (portal hypertension, portal vein hypertension), attention must be paid to reducing individual risk factors. Behavioral risk factors Consumption of stimulants Alcohol (woman: > 40 g/day; man: > 60 g/day). Primary prophylaxis Primary prophylaxis aims to prevent initial variceal bleeding. The risk of this is approximately 30%. An increased risk of bleeding, … Portal Hypertension: Prevention

Portal Hypertension: Medical History

Medical history represents an important component in the diagnosis of portal hypertension (portal hypertension, portal hypertension). Family history Is there a high incidence of liver disease in your family? Social history Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? How long have these changes been present? Do you often feel … Portal Hypertension: Medical History

Portal Hypertension: Or something else? Differential Diagnosis

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Erosive gastritis (gastric mucosal erosions). Upper gastrointestinal bleeding (GIB; gastrointestinal bleeding). Mallory-Weiss syndrome – longitudinal tears of the mucosa (mucous membrane) and submucosa (tissue layer between the mucosa and muscle layer) of the esophagus occurring more frequently in alcoholics, which can be associated with potentially life-threatening … Portal Hypertension: Or something else? Differential Diagnosis

Portal Hypertension: Complications

The following are the most important diseases or complications that may be contributed to by portal hypertension (portal hypertension; portal hypertension): Blood, hematopoietic organs – Immune system (D50-D90). Anemia (anemia) Leukopenia (reduction of white blood cells). Splenomegaly (enlargement of the spleen), unspecified. Thrombocytopenia (decrease in blood platelets). Cardiovascular system (I00-I99) Esophageal varices (varicose veins of … Portal Hypertension: Complications

Portal Hypertension: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes [jaundice (yellowing of the skin); tendency to hematoma (bruising) due to impaired clotting; hepatic skin signs: Dupuytren’s contracture (synonyms: Dupuytren’s contracture, Dupuytren’s disease) – nodular, cord-like … Portal Hypertension: Examination