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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

What are 2 other collateral paths?

1. Liver hilum
2. Splenic hilum