Portal Hypertension Research Paper

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Essay 93: Portal Hypertension

The term portal hypertension refers to any pathological process obstructing blood flow from the portal vein, through the liver parenchyma, and into the hepatic vein en route to the right side of the heart. Most cases of portal hypertension are caused by cirrhosis, or scarring of the liver following chronic injury. In the U.S., the leading causes of cirrhosis are alcohol abuse and viral hepatitis (Hepatitis B or C). Less often, the liver damage results from genetic disorders including hemochromatosis, marked by iron overload; Wilson's disease, a rare disease resulting in copper overload; and autoimmune hepatitis. In much of the developing world, the leading culprits include the Hepatitis B virus, especially …show more content…
In mild to moderate portal hypertension, the body attempts to compensate by means of collateral venous circulation, in effect shunting blood away from the damaged liver. These collateral veins take the form of esophageal varices and hemorrhoids, both of which are prone to bleeding. Some patients develop clusters of spidery veins around the umbilicus, a condition known as caput medusa, or Medusa's head, owing to the tortuous appearance of these veins. As portal hypertension worsens, the failing liver produces insufficient amounts of certain blood proteins, in particular albumin. This normally abundant protein acts as a sponge in the veins and capillaries, maintaining an adequate plasma volume. In hypoalbuminemia, however, fluid progressively seeps through the walls of these blood vessels and accumulates in the abdominal cavity, a condition known as ascites. Patients with severe ascites are at risk for developing SBP (spontaneous bacterial peritonitis) and dying of septic …show more content…
People with alcohol dependence, for example, can quit drinking. People with hemochromatosis can undergo phlebotomy at monthly intervals to control their iron stores. Viral hepatitis can be treated, or at least contained, with interferons. Parasitic infections can be eradicated, especially if diagnosed in their early stages. Once extensive liver damage occurs and gives way to cirrhosis, however, the treatment options dwindle. Patients with ascites are often treated with a procedure called paracentesis, followed by intravenous albumin replacement. Paracentesis is a sophisticated term for puncturing a patient's abdomen with a large needle and removing the ascites fluid - sometimes several liters of it. These patients also receive antibiotics as prophylaxis against
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