Portal Hypertension

Etiology

  • Post-hepatic: budd-chiari (hepatic vein thrombosis), constrictive pericardial disease, advanced right sided heart failure
  • Hepatic: cholestatic or inflammatory/fibrotic liver disease--> cirrhosis
  • Pre-hepatic: portal vein thrombosis (hypercoaguable state, malignancy, cirrohsis, nearby inflammatory process, cirrhosis, myeloproliferative d/o), splenic vein thrombosis, schistosomiasis

Risk Factors

  • Hepatic inflammation/fibrosis→ known liver disease from viral/etoh/other chronic hepatitis→ cirrhosis
  • Hyper-coagulable state--> hepatic, portal or splenic vein thrombosis

Symptoms

  • Sob
  • Fatigue
  • Abdominal swelling
  • Peripheral edema

Physical Exam Findings

  • Ascites
  • Jaundice
  • Icterus
  • Edema
  • Splenomegaly, sometimes hepatomegaly
  • Spider angiomata, palmar erythema

Tests

Links