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Portal Hypertension

By

The Manual's Editorial Staff

Reviewed/Revised Apr 2023
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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.

Blood Supply of the Liver

Blood Supply of the Liver

What causes portal hypertension?

What are the complications of portal hypertension?

The main complication is:

  • Bleeding

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:

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)

How can doctors tell I have portal hypertension?

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)

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