What is portal hypertension?
The portal vein is the large blood vessel that brings blood from your intestines to your liver.
Hypertension is a medical term for high blood pressure.
So, portal hypertension is high blood pressure in your portal vein.
Most people get portal hypertension from cirrhosis Cirrhosis of the Liver Your liver is a football-sized organ on the right side of your belly, just below your ribs. It has many important jobs: To make a liquid (bile) that helps your body digest fat To process nutrients... read more (a liver disease in which scar tissue replaces normal liver tissue)
Portal hypertension is dangerous because it can lead to bleeding in your stomach and esophagus (the tube that connects your throat to your stomach)
Medicine can lower blood pressure in your portal vein
You will need emergency treatment if you have bleeding in your stomach and esophagus
Blood Supply of the Liver
What causes portal hypertension?
Portal hypertension is usually caused by:
Cirrhosis is severe liver scarring. The scarring blocks blood flow in the liver and raises the pressure in the blood vessels that go to the liver. You can get cirrhosis from chronic liver diseases such as chronic hepatitis C Chronic Hepatitis Chronic hepatitis is inflammation (swelling) of the liver that lasts for 6 months or longer. Chronic hepatitis usually develops from acute hepatitis but you may not know you had acute hepatitis... read more and alcohol-related liver disease Alcohol-Related Liver Disease Your liver is a football-sized organ on the right side of your belly, just below your ribs. It has many important jobs: To make a liquid (bile) that helps your body digest fat To process nutrients... read more .
What are the complications of portal hypertension?
The main complication is:
The high blood pressure in the portal vein forces blood into other blood vessels. These other blood vessels include those around your stomach and esophagus (the hollow tube that carries food to your stomach). These blood vessels swell up with blood, which makes them bleed easily. Bleeding from these vessels can be severe and even fatal.
What are the symptoms of portal hypertension?
Portal hypertension itself doesn't cause symptoms, but its effects may cause symptoms:
Swelling and a tight feeling in the belly from fluid building up there (ascites Ascites Ascites is the accumulation of protein-containing (ascitic) fluid within the abdomen. Many disorders can cause ascites, but the most common is high blood pressure in the veins that bring blood... read more )
Swollen veins on your belly
If portal hypertension causes bleeding from your stomach and esophagus, you may have:
Throwing up blood or black stuff that looks like coffee grounds
Dark stools (poop) that look like tar
Bleeding from your anus (the opening where stool comes out)
You may also have symptoms of liver failure Liver Failure Your liver is an organ in the upper right part of your belly. The liver does many important things: Breaks down chemicals and medicines Makes digestive fluid called bile Produces many important... read more such as:
Bleeding and bruising more easily
How can doctors tell I have portal hypertension?
Doctors suspect portal hypertension if you have:
Swollen veins on your belly
There aren't any specific tests for portal hypertension, but doctors may do tests on your liver, including:
Imaging tests such as ultrasound Ultrasonography Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography... read more , MRI (magnetic resonance imaging) Magnetic Resonance Imaging Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography... read more , or CT (computed tomography) scan Computed Tomography Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography... read more
If you're bleeding, doctors will look down your throat with a flexible scope (endoscope). The scope will let them see exactly where in your esophagus and stomach the bleeding is coming from. They can then treat the bleeding.
How do doctors treat portal hypertension?
Bleeding from the veins of the stomach and esophagus is a medical emergency. Doctors treat this bleeding by:
Giving medicines to slow the bleeding
Giving blood transfusions
Closing off the bleeding veins with rubber bands or clips (using an endoscope)
To prevent bleeding from the veins of the stomach and esophagus, doctors use:
Medicines to lower blood pressure
Placement of a tube into the liver to connect the portal vein to hepatic vein (portosystemic shunting) which lowers the pressure in the portal vein
Surgery to lower the pressure in the portal vein by redirecting blood so it doesn’t pass through the liver (portosystemic shunting)
As a last resort, liver transplant (surgery to remove a failing liver and replace it with a healthy one from a donor)