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Portal Hypertension

Get the facts on Portal Hypertension treatment, diagnosis, staging, causes, types, symptoms. Information and current news about clinical trials and trial-related data, Portal Hypertension prevention, screening, research, statistics and other Portal Hypertension related topics. We answer all your qestions about Portal Hypertension.

Question: can you get right sided heart failure with portal hypertension? I am confused abut the whole portal hypertension thing. Is portal hypertension a problem with blood going in or out?

Answer: RV failure: In failure due to right ventricular dysfunction, systemic venous pressure increases, causing fluid extravasation and consequent edema, primarily in dependent tissues (feet and ankles of ambulatory patients) and abdominal viscera. The liver is affected most, but stomach and intestines also become congested; fluid accumulation in the peritoneal cavity (ascites) can occur. RV failure commonly causes moderate hepatic dysfunction, with usually modest increases in conjugated and unconjugated bilirubin, PT, and hepatic enzymes (eg, alkaline phosphatase, AST, ALT). The impaired liver breaks down less aldosterone, further contributing to fluid accumulation. Chronic venous congestion in the viscera can cause anorexia, malabsorption and protein-losing enteropathy (characterized by diarrhea and marked hypoalbuminemia), chronic GI blood loss, and rarely ischemic bowel infarction. Portal hypertension is caused most often by cirrhosis (in developed countries), schistosomiasis (in endemic areas), or hepatic vascular abnormalities. Consequences include esophageal varices and portal-systemic encephalopathy. Diagnosis is based on clinical criteria, often in conjunction with imaging studies and endoscopy. Treatment involves prevention of GI bleeding with endoscopy, drugs, or both, and sometimes with portocaval shunting.

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