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Portal Hypertension

Walter M. Kim, PhD, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Increased portal venous pressure >5 mm Hg that occurs in association with splanchnic vasodilatation, portosystemic collateral formation, and hyperdynamic circulation

  • Most commonly ...

DIAGNOSIS

HISTORY

  • Ascites; symptoms of heart failure including chest pain, shortness of breath, and/or edema

  • Hematemesis

  • Melena

  • Oliguria

  • Jaundice

  • Weakness/fatigue

  • History of chronic liver disease

  • Alcoholic he...

TREATMENT

GENERAL MEASURES

  • Avoid sedatives that may precipitate encephalopathy.

  • Limit sodium intake because cirrhotic patients avidly retain sodium (<2 g sodium per day).

MEDICATION

First Line

  • Prophylax...

ONGOING CARE

DIET

  • In cirrhosis, patients retain sodium, so restrict sodium intake to <2 g daily

  • Alcohol abstinence

PROGNOSIS

  • Hepatic reserve defined by Child-Pugh classification: rating based on enceph...

REFERENCES

1
de Franchis  R; for Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing ...

CODES

ICD10

K76.6 Portal hypertension 

SNOMED

34742003 Portal hypertension (disorder) 

CLINICAL PEARLS

  • Portal hypertension can be diagnosed based on physical examination in the setting of known risk factors, specifically cirrhosis.

  • Endoscopic treatment is successful for acute variceal he...

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