Portal Hypertension

Question 1

Portal hypertension due to?

Answer 1

1. Pre-hepatic portal venous obstruction
2. Intra-hepatic portal venous obstruction
3. Post-hepatic portal venous obstruction

Question 2

Pre-hepatic portal venous obstruction due to?

Answer 2

Portal vein thrombosis or splenic vein obstruction

Question 3

Intra-hepatic portal venous obstruction due to?

Answer 3

cirrhosis,

metastatic tumor, or schistosomiasis

Question 4

Post-hepatic portal venous obstruction due to?

Answer 4

constrictive pericarditis,

tricuspid insufficiency,

CHF, or

Budd-Chiari syndrome

Question 5

How does portal hypertension occur?

Answer 5

Portal venous obstruction results in increased use of venous collaterals of the portal-systemic
anastomoses

Question 6

Increased use of portal systemic anastamoses lead to?

Answer 6

1. varices in the submucosal veins of the esophagus,
   rectal veins, and
   paraumbilical-inferior epigastric veins
2. increased portal vein pressure results in
   decreased capillary fluid resorption, leading to collection of fluid in the peritoneal cavity (ascites

Question 7

Portal hypertension clinical signs?

Answer 7

Splenomegaly; esophageal varices; hemorrhoids;
caput medusae (periumbilical varicose veins),
hematemesis;
spider angiomas; hypotension;
pallor;
ascites

Question 8

Portal hypertension treatment?

Answer 8

Splenectomy for splenic vein thrombosis

Band ligation or sclerotherapy for variceal bleeding

Anticoagulation for isolated portal vein thrombosis

Treatment of cirrhosis