In medicine Portal hypertension is high blood pressure in the portal vein and its tributaries. Portal hypertension is caused by obstruction of the blood flow into, through or out of the liver.
It is often defined as a portal pressure gradient (the difference in pressure between the portal vein and the hepatic veins) of 10 mmHg or greater.
The portal vein is the large vein through which oxygen-depleted blood from the stomach, the intestines, the spleen the gallbladder and the pancreas flows to the liver. The portal vein is not a true vein, because it conducts blood to capillary beds in the liver and not directly to the heart.
This blood is rich in nutrients that were extracted from food, and the liver processes these nutrients; it also filters toxins that may have been ingested with the food.
The blood leaves the liver and flows to the heart in the hepatic veins.
What are the symptoms to look out for?
How is a diagnosis made?
A range of tests can be carried out to make a diagnosis:
Treatment of Portal Hypertension
Mild symptoms do not require treatment, but bleeding does require treatment. If portal hypertension causes diarrhea or poor weight gain, a dietitian will advise on changes to the child’s diet to ensure they absorb sufficient nutrients and calories.
Treatment for varices
If the varices have inflamed the lining of the esophagus or stomach, a medicine may be given to protect the lining and help it to heal.
Treatment of bleeding
Immediate medical attention is needed if a child is vomiting blood or passing blood in their stools. If possible take a sample of the vomit or stool with you to hospital and inform the doctors about your child’s portal hypertension and the current symptoms.
While in hospital some of the following will be done:
Once stable, your child may be given an endoscopy to look at the varices that are bleeding. Treatment options will be considered and discussed with you. These may include injecting the varices to prevent the small veins bleeding (sclerotherapy) or placing special rubber bands around them (banding) to remove the varices. Repeated treatments may be necessary to reduce the chance of the varices bleeding again.