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.

Question: Can you get pulmonary edema from portal hypertension? I know in heart failure the fluid from the left ventricle backs up and goes into the lungs. But in portal hypertension, the fluid backs up into the spleen and then it backs up into the vena cava or the arterial system? Im trying to trace the blood flow. I dont even know if its arterial or venous blood. we do not get good pics here Are varices in the esophagus arterial or venous?? thanks

Answer: Blood backs up into the vena cava----right sided heart failure (the one you described is Left-sided h.f.) varices are veins- basically hemorrhoids of the esophagus. you don't get pulmonary edema from portal hypertension, but someone with portal hypertension/liver disease likely has "leaky vessels" and could be prone to fluid overload and pu;monary edema

Question: What are the side effects following esophageal banding of the varices due to portal hypertension? My husband had the procedure done a week ago. He can't hardly eat or drink w/out feeling pain in his chest and feeling like he has indigestion or something stuck in his esophagus.

Answer: Go to that website http://www.murrasaca.com/Esophagealvarices.htm

Question: Does anyone know about Portal Hypertension? I am asking cause my mom has it. Do you know anyone with this?

Answer: Portal hypertension is a medical condition which develops as a result of increased pressure in the portal vein. The portal vein is a large vein that passes through the liver. When any condition that causes liver damage like liver cirrhosis or tumor or a large blood clot, the pressure in the portal vein increases resulting in collection of fluid in the abdomen(called ascitis).

Question: where can i find a site about biliary surgery in portal hypertension?

Answer: Try DrKoop.com if they dont have the answer they usually have a link

Question: what is the importance of DSRS IN PEDIATRIC PORTAL HYPERTENSION?

Answer: Go to www.medicinenet.com/portal_hypertension.

Question: can alagilles syndrome be mistook portal pulmonary hypertension? do they have the same symptoms my son devlyn died a couple of years ago his post mortem report states that he died from severe Portal- pulmonary hypertension I have just been able to look through the medical notes and everything I have seen tells me that he had alagilles syndrome even on the mri results they state the combination of presumed chronic liver disease with portal hypertension and vertebral anoomalies suggest underlying alagilles syndrome Please I attach the final report I have from my solicitors they say i can not continue my complaint my son died while having a colopsy please could you forward me the the facts I should be looking at in the notes so that I may finally but closure to this .... I have all the results and medical notes they all relate to what I have seen on the net today but I need some one to advise me definately passed down from his dad he been on medication 20 iyears AMLODIPINE,MICARDIS,SPIRONOLACTONE,PERINDOPRIL,BISOPROLOL. Every day extra vessels on heart but never been asked about genes . Im ok just need to understand everything. Thank u for all replys. Dev's website on cfp56@piczo.com definately passed down from his dad he been on medication 20 iyears AMLODIPINE,MICARDIS,SPIRONOLACTONE,PERINDOPRIL,BISOPROLOL. Every day extra vessels on heart but never been asked about genes . Im ok just need to understand everything. Thank u for all replys. Dev's website on cfp56@piczo.com would like to know websites to compare medical notes. No legal side to this i just like answers. Thank u MRI results:abdomen moderatevolume of ascites throughout abdominal cavity, hepatic architecture is abnormal with caudate lobe hypertrophy relative atrophy of the right liver, degree of splenomegaly, the extra heptic portol vien, splenic and superior mesentric of hemi vertebrae affecting both the lower thoracic and lumbar vertebral bodies. the combination of presumed chronic liver disease with portol hypertension and vertebral anormalies suggest underlying allegele syndrome.... 2/10/2004 Spine lumar x-ray: there is abnormalites noted in both lower thoracic and lower lumbar spine, there is a hemi verebra noted at T11 with loss of normal vertebral body and pedicle of the left side of of T11 Furthermore there is a butterfly configuration of L5. some abnormality of modelling of T10 is also noted. These features would be in keeping with alagilles....2/10/2004

Answer: Alagille syndrome is an autosomal dominant disorder also referred to as Alagille- Watson syndrome, syndromic bile duct paucity and arteriohepatic dysplasia The course is characterized by recurrent episodes of cholestasis. The long- term prognosis is related to the severity and duration of early cholestasis, severity of complex cardiovascular abnormalities and the severity of liver disease and its associated portal hypertension. Portal Hypertension Synonyms and related keywords: cirrhosis, variceal hemorrhage, ascites, portal vein. Portal hypertension may be defined as a portal pressure gradient of 12 mm Hg or greater and is often associated with varices and ascites. Many conditions are associated with portal hypertension, of which cirrhosis is the most common cause. Alagille syndrome is a dominantly inherited systemic disorder consisting of abnormalities of the liver, heart, eye, spine, facies, kidney, vasculature and other organs. It is caused by mutations in Jagged1, a ligand in the Notch signaling pathway Portal hypertension develops in up to 1/3 of patients with severe hepatic AGS.

Question: What is the function of the hepatic portal vein? The liver has the vena cava to drain blood from it. So what is the point of the portal vein? And if you have portal hypertension, Is that in the vena cava or portal vein and how does it affect the heart? Thank you

Answer: woo woo woo...Lets take it one step at a time., the he portal vein has nothing to do with the heart ...its just a major liver vessels., and it is where all the sugar., simple and complex fats and AA(aminoacid) gets transmitted to the liver for further processing. yes the liver does need vena cava but the liver does not process this blood., the heart does ...and the portal system of the liver which is heportal vein is the branch in which the blood must be supply to the liver . Every major system does have their portal systems ..in which the blood must stop before further transport ..the liver ...hypophyseal in the brain and the kidney also

Question: how to differentiate clinically between liver cirrhosis, portal hypertension, acute liver failure ? and hepatic encephalopathy

Answer: portal hypertension, acute liver failure and hepatic encephalopathy and complications of liver cirrhosis. i'll have to explain the blood circulation on the liver to make it clear. our liver has 2 blood supply and 1 outlet. the outlet is the vena cava. if you have cirrhosis. the liver is less permeable to blood. which means the blood do not easily pass. if thats the case your pressure will increases because of the constant supply but decrease in outflow. causing portal hypertension. hepatic encephalopathy is caused by increase in ammonia. a product of our body's metabolism.which means waste. too much ammonia will be toxic to the brain. with the liver not functioning properly the body cannot metabolize ammonia. causing ammonia build up affecting our brain. causing swelling or encephalopathy. acute liver failure means malfunction of the liver. non functioning liver. thats very fatal.

Question: my dad age 55 suffering from cirrhosis, portal hypertension and ascites plz tell me more abt this?

Answer: Cirrhosis is a chronic degenerative disease in which normal liver cells are damaged and are then replaced by scar tissue.Cirrhosis changes the structure of the liver and the blood vessels that nourish it. The disease reduces the liver's ability to manufacture proteins and process hormones, nutrients, medications, and poisons. Most of the liver's supply of blood comes from the intestinal veins as the blood returns to the heart. The main vein that returns blood from the intestines is called the portal vein. As the portal vein passes through the liver, it breaks up into increasingly smaller and smaller veins. The tiniest veins (called sinusoids because of their unique structure) are in close contact with the liver cells. In fact, the liver cells line up along the length of the sinusoids. This close relationship between the liver cells and blood from the portal vein allows the liver cells to remove and add substances to the blood. If blood can’t flow easily through the liver because of cirrhosis, the blood gets slowed down in this vein and the pressure inside the vein increases. This higher blood pressure in the portal vein is called portal hypertension. The most common cause of portal hypertension is cirrhosis, or scarring of the liver. Cirrhosis results from the healing of a liver injury caused by hepatitis, alcohol abuse, or other causes of liver damage. In cirrhosis, the scar tissue blocks the flow of blood through the liver and slows its processing functions. Portal hypertension may also be caused by thrombosis, or clotting in the portal vein. As far as the ascites, this is defined as an abnormal accumulation of fluid in the abdomen. Cirrhosis, is responsible for 80% of all instances of ascities in the United States. As cirrhosis of the liver becomes severe, signals are sent to the kidneys to retain salt and water in the body. The excess salt and water first accumulates in the tissue beneath the skin causing edema.Fluid also may accumulate in the abdominal cavity between the abdominal wall and the abdominal organs. This accumulation of fluid (called ascites) causes swelling of the abdomen, abdominal discomfort, and increased weight.

Question: How can portal hypertension lead to encephalopathy? Can anyone tell me how can portal hypertension lead to encephalopathy? Also what tests are used to diagnose encephalopathy? Are there any changes specific for it on eeg,mri or pet scans? Can encephalopathy still be there with normal mri/nonspecific test findings but having the clinical presentation? Are there any blood/urine tests helpful in diagnosis

Answer: Portal hypertension occurs when liver disease impairs blood flow through the liver. Hepatic encephalopathy occurs when liver disease is present, and the liver is not converting toxic ammonium into urea for excretion by the kidneys, and it is what produces the resulting encephalopathy. Here is some additional information............... http://pubs.niaaa.nih.gov/publications/a…

Question: Does portal hypertension have ant symptoms? Thankyou

Answer: yes- the symptoms are basically the sequelae of cirrhosis- ascites, liver failure, encephelopathy, esophageal varices, enlarged spleen. tx can be medical or surgical (beta blockers or shunt)

Question: how long to people with portal hypertension and cirrhosis and liver cancer have to live if they have all of? these symptoms this "person" also has hep c and has been an alcholic for years she doesn't drink everyday but she does often she sleeps all the time she coughs all the time she coughs up blood too she hardley eats she has fluid in her lungs because she smokes all the time its called something but i don't remember her body is swallon because of all of the fluid that has built up in her stomach i was just wandering with all these bad things that have happened how long does she have left? she been seeing doctors for all of these things but doesn't really talk to me about it thank all of you in advance she doesn't take good care of herself either she has depression issues and is on anxiety meds she sets around and does nothing to help herself everyone has told her what she needs to do she just doesn't want to do it

Answer: People in this situation usually just have their symptoms controlled.......for example, for the swelling to the abdomen called ascites, the docs can regularly drain the excess fluid by inserting a small drain thru the skin called a paracentesis. Portal hypertension is probably causing esophageal varices, which is why she is coughing up blood. These can be treated if they rupture, but its a big emergency. With regards to the liver cancer, it all depends where it is and what typre of cancer. Is the liver the primary site or a metastatic site. Would your friend be well enough for surgery/ radiation/ chemo. It sounds like your friend is very sick.It would be impossible to know how long she would live like this. If she takes good care of herself, doesn't drink, and seeks regular and prompt medical care for control of her symptoms she may have a few months or even years. Hope this helps. Sorry your friend is so sick.

Question: My 9 year old son died of pulmonary portal hypertension? Any advice welcome.. I will give more details later.. He died in theartre having camera to look inside.....2 days after being in theartre....never took no bloods that am..was told to administer platlets..but never until last min....and used o neg blood when he o pos I have all medical records.....they tryin to kick it out with the 7 doctor rule... Top specialist worldwide .. a case of not what you know its who you know to cover your mistakes,,,any one wanting medical notes are welcome...take a few days Many thanks trujillo you may have completed another piece of the puzzle.all wisedom u have is appreciated.....

Answer: Oh my, my, my... I'm so very sorry for you, but there aren't words that are going to help. The O neg blood for an O pos patient shouldn't have been a problem, but the platelets should have been give early. And they were just in there looking around with a camera?? It sounds like something may have been punctured accidentally. I think I would find a very good lawyer. He can obtain the medical records and hire someone to interpret them to find out what went wrong. Someone should pay for their mistake. It will not bring your son back, but it might save someone else's. God bless!

Question: portal vein hypertension with spleenomegaly? my hb levels have averaged 9 to 10mg for the past several years, my spleen is enlarged, portal vein calliberations come to 12 to 15mm. i have undergone exhaustive testing, but could not pin point any reason for anemia. i have gilbirds syndrom and haemorroids gd 2 with no blood leakages, i was passing undiged food, after taking h pylori kit, my stool formation showed fully digested food,. what can be the possible reasons for my anaemic conditions my age is 55 years. rksapru

Answer: micro-haemorrhages and malabsorption from oedema

Question: What is the difference between collateral vessels and varices? I am writing a paper about portal hypertension, and both collateral vessels and varices are mentioned in my research. Are they the same thing or different? Any help with these concepts would be greatly appreciated!

Answer: In portal hypertension esophageal varices are just like varicose veins in the back of some peoples legs but occur in the oesophagus. They occur as a result of the blood not being able to flow through the liver as easily as it should and backing up in the esophageal blood vessels causing them to dilate with blood. They are very dangerous because the sufferer often doesn't know they have them until they swallow something and rupture these vessels causing a big bleed to occur which can kill them if they don't get medical help very soon. Treatment is to place a long expanding catheter down the throat into the esophagus and fill it with either cold water to help shrink the veins or with air. Either way the object is to inflate the catheter and put pressure on the blood vessels to stop the bleeding. Collateral vessels are when something interrupts the blood supply to some tissue and the arteries feeding that tissue can put out new shoots of artery around the blockage so that minimal tissue is left without circulation. This often happens in heart muscle after a small infarct (blockage in the coronary arteries) blocks the flow. It's part of the body's repair system at work. So, there are two main differences. 1. Esophageal varices are the engorged and distended veins in the esophagus which can easily rupture and cause a big bleed. 2. Collateral vessels is the ability of arteries being able to make new smaller arteries in an attempt to get around a blood flow blockage to minimize necrosis of that tissue. Hope this helped a bit.