Flashcards in Lesson 5C Deck (22)
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1
What is splenomegaly associated with? (3)
1. Leukemia
2. Lymphoma
3. Portal hypertension
- any disease that involves abnormal red blood cells being destroyed
2
What are important signs of portal hypertension? (2)
1. Enlarged spleen
2. Caput Medusae
3
What does portal vein thrombosis cause? (5)
1. Reduced blood supply to the liver
2. Pancreatitis
3. Cirrhosis
4. Diverticulitis
5. Cholangiocarcinoma
4
What does cavernous transformation of the portal vein occurs in?
Long standing PVT
5
Cavernous transformation
Bridging collaterals form around the occlusion
6
What happens with portal hypertension?
The hepatic arteries will enlarge and become tortuous exhibiting aliasing frequency shifts
7
What happens as portal venous flow to the liver decreases?
Arterial flow increases
8
What does increased arterial flow occurs with?
Development of large collaterals and hepatopetal flow
9
What are symptoms of portal hypertension? (3)
1. Gastrointestinal bleeding
2. Ascites
3. Encephalopathy
10
Gastrointestinal bleeding
Black tarry stools and vomiting blood
- rupture and hemorrhage from varices
11
Encephalopathy
Confusion and forgetfulness are caused by poor liver function
12
What are reduced with encephalopathy? (2)
1. Platelets
- clotting
2. White blood cells
13
What is the treatment for portal hypertension?
Most causes of portal hypertension cannot be treated
14
What does the treatment focus on for portal hypertension?
Preventing or managing the complications such as bleeding from varices
15
TIPS
Transjugular intrahepatic portosystemic shunt
16
Transjugular intrahepatic portosystemic shunt
A stent is placed in the middle of the liver that connects the hepatic vein with the portal vein to reroute blood flow in the liver to help relieve pressure in abnormal veins
17
What are TIPS complications? (7)
1. Intraperitoneal hemorrhage
2. Shunt thrombosis
3. Neck hematoma
4. Compromise of hepatic blood supply
5. Failed stent deployment, expansion, migration or fracture
6. Biliary obstruction
7. Delayed shunt stenosis, HV stenosis
18
What happens when you put colour flow on the site of stenosis?
Aliasing
19
What should you evaluate when you have a stent?
The hepatic vein distal to it
20
DSRS
Distal splenorenal shunt
21
What does distal splenorenal shunt do? (3)
1. Connects the vein from the spleen to the vein from the left kidney
2. Reduces pressure in varices
3. Helps control bleeding
22
