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Portal hypertension is defined as a sustained elevation of portal pressure above normal.

Normal pressure in the portal vein is low (5 to 10 mmHg)

Portal hypertension (>10 mmHg) most commonly results from increased resistance to portal blood flow.

Causes

a combination of increased portal venous inflow and increased resistance to portal blood flow

Portal hypertension may arise from increased blood flow, but the low outflow resistance of the normal liver makes this a rare clinical problem.

pathogenesis

increased splanchnic venous inflow

Vasodilators (Nitric oxide)

Increased resistance to portal blood flow

Prehepatic causes

Intrahepatic causes: classic sinusoidal cause -- cirrhosis

Posthepatic causes

Clinical Features

development of portal-systemic collateral channels

splenomegaly with hypersplenism

ascites

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15y ago

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