LIVER & BILIARY TRACT 8 Portal hypertension etioplogy pathopysiology

9. PORTAL HYPERTENSION

Portal hypertension may result from disease of the liver  leading

to  intrahepatic  obstruction or an obstruction to  the  flow  of

blood in the extrahepatic portal system

As  a  result,  abnormal channels of  communication  between  the

portal  system (PS) and systemic veins (SV) open up and a  common

site are the oesophageal veins Fig. above

ETIOLOGY

The majority of cases are due to intrahepatic obstructions  (90%)

and the disorders include:

*  Nutritional cirrhosis (commonest)

*  Postnecrotic cirrhosis and

*  Biliary cirrhosis

PATHOPHYSIOLOGY

The normal pressure is less than 300 mm of water and this can  be

measured by introduction of a cannula into portal tributaries and

shows  an  elevation.   There is in addition,  an  elevation  of

splenic pulp pressure.

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