- Post-hepatic: budd-chiari (hepatic vein thrombosis), constrictive pericardial disease, advanced right sided heart failure
- Cirrhosis (hepatic): cholestatic or inflammatory/fibrotic liver disease; causes ~90% of portal hypertension
- Pre-hepatic: portal vein thrombosis (hypercoaguable state, malignancy, cirrohsis, nearby inflammatory process, cirrhosis, myeloproliferative d/o), splenic vein thrombosis, schistosomiasis
- Hepatic inflammation/fibrosis→ known liver disease from viral/etoh/other chronic hepatitis→ cirrhosis
- Hyper-coagulable state--> hepatic, portal or splenic vein thrombosis
- Abdominal swelling
- Peripheral edema
- Splenomegaly, sometimes hepatomegaly
- Spider angiomata, palmar erythema
- US w/flows to assess liver parenchyma, hepatic and portal vein, splenomegaly, ascites; or CT
- Endoscopy for varices
- Labs to assess for hepatic disease: LFTs, chronic hep b, hep c, CBC (low plt w/portal htn)
- Occult chronic liver dz: ferritin, anti-sm muscle ab, cerruloplasmin, alpha-1 anti-trypsin, liver bx if cryptic