Portal hypertension
Portal hypertension is the elevated blood pressure in your portal vein and the smaller veins that branch off from it — your portal venous system.
overview
Portal hypertension is a serious medical condition that occurs when there is increased blood pressure within the portal venous system — the network of veins that carries blood from the stomach, intestines, spleen, and pancreas to the liver. This increase in pressure is usually due to a blockage or resistance to blood flow through the liver, commonly caused by cirrhosis, which is the scarring of liver tissue.
The most common cause of portal hypertension is cirrhosis, a condition in which healthy liver tissue is replaced by scar tissue. This scarring disrupts normal blood flow through the liver, increasing pressure in the portal vein. Other causes include blood clots in the portal vein (portal vein thrombosis), schistosomiasis (a parasitic infection), and certain congenital abnormalities of the blood vessels.
Symptoms & Diagnosis
Portal hypertension can lead to a number of serious complications. One of the most significant is the development of varices, which are swollen veins — usually in the esophagus or stomach — that can rupture and bleed, posing a life-threatening risk. Ascites, or the accumulation of fluid in the abdomen, is another common complication. Patients may also develop splenomegaly (enlarged spleen) and hepatic encephalopathy, a condition where toxins that the liver would normally filter begin to affect brain function, causing confusion, drowsiness, or even coma.
Symptoms of portal hypertension may not be obvious in the early stages. As the condition progresses, patients may experience abdominal swelling, gastrointestinal bleeding (vomiting blood or passing black, tarry stools), fatigue, and mental changes. Diagnosis is often made through imaging studies such as ultrasound, CT scan, or MRI, and sometimes through direct measurement of portal pressure during specialized procedures.
Treatment focuses on managing the underlying cause and preventing complications. Medications such as beta-blockers may be used to reduce portal pressure and the risk of bleeding. Endoscopic procedures can treat bleeding varices. In some cases, procedures like TIPS (transjugular intrahepatic portosystemic shunt) are performed to create new pathways for blood flow, reducing pressure in the portal system. For patients with severe liver damage, liver transplantation may be the only effective long-term solution.
- Jaundice
- loss of appetite
- Swelling in right upper abdomen
- Pain in right upper abdomen
- Weight loss