Portal hypertension is defined as a

increase in portal vein pressure above the

normal level of 5 to 10 mm Hg. In
established cases of portal hypertension,
direct portal pressure measurement may be
elevated to 15 mm Hg or even more.
Portal
hypertension is due to obstruction
somewhere in the portal veins draining
into the inferior venacava (post- hepatic)

 The Manifestation are:

 Oesophegeal Varicosity
 Haemorrhoids
 Splenomegaly &
Hypersplenism
 Liver Failure
 Pre – hepatic causes:– 20%
Congenital atresia or Hypoplasia.
Trauma
Tumor
Isolated spleenic vein thrombosis.

 Hepatic causes:– 80%.

Nutritional cirrhosis.
Postnecrotic cirrhosis.
Billary cirrhosis.
Haemochromatosis.
Wilson's disease.
 Post Hepatic:– Rare
Budal chair syndrome.
Right sided heart failure.
 Pre-hepatic causes  Hepatic Causes  Post- Hepatic Cause
 Management three stages:
 Resuscitation:
 Blood volume should be maintained.

 Saline should be avoided because of ascites.

 Pulse rate, blood pressure should be monitored.

 Gastric acid secretion should be decreased.

 Diagnosis:
 Endoscopy
Specific Treatment:
 Vasopressin.

 Endoscopic Variceal Sclerosis.

 Balloon Tamponade.
 Shock

 Clotting Problems

 Ascites

 Liver Failure