Presentation
Splenomegaly is a cardinal sign (unusual for portal hypertension to be present without some degree of splenomegaly, either seen clinically or on USS) Collateral vessels may be visible Caput medusae- dilated veins around the umbilicus (said to look like [dundeemedstudentnotes.wordpress.com]
Aetiology: Clinical presentations: Portal hypertension with preserved liver function. Massive splenomegaly (>10 cm below the left subcostal margin)-present in >95 % of patients. Dilated superficial abdominal veins- in15 %. [gastroenterologybook.com]
Diagnosis Treatment Conclusion Incidence of ParaAnastomotic Aortic Aneurysms True ParaAnastomotic Aortic Aneurysms False ParaAnastomotic Aortic Aneurysms Infected ParaAnastomotic Aortic Aneurysms Presentation Management Operative Techniques and Results [books.google.com]
Mercaptopurine. // Reactions Weekly;Aug2014, Vol. 1512 Issue 1, p27 The article presents a case study of a 12-year-old boy who was admitted to hospital for non-cirrhotic portal hypertension after being treated for Cohn's disease (CD). [connection.ebscohost.com]
Splenomegaly is the second most frequent mode of presentation. These patients may present with splenomegaly or with hypersplenism. [musculoskeletalkey.com]
Entire Body System
- Hunting
Google Scholar | Medline Zeegen, R., Stansfeld, A.G., Dawson, A.M., and Hunt, A.H. : Prolonged survival after portal decompression of patients with non-cirrhotic intrahepatic portal hypertension. Gut, 11: 610, 1970. [journals.sagepub.com]
- Fishing
Kiser TH, Maclaren R, Fish DN. Treatment of hepatorenal syndrome. Pharmacotherapy. 2009 Oct. 29(10):1196-211. [Medline]. Appenrodt B, Zielinski J, Brensing KA, Heller J, Sauerbruch T, Schepke M. [medscape.com]
Immune System
- Splenomegaly
The tropical splenomegaly syndrome: a current appraisal. Rev Inst Med Trop Sao Paulo 1976 ; 18: 54 –70. 5. Crane GG.. Tropical splenomegaly. II. Oceania. Clin Haematol 1981 ; 10: 976 –82. [nejm.org]
[…] and hypersplenism Differential diagnosis Dilatation of splenic veins at the splenic hilum without splenomegaly may occur in situations such as state of increased perfusion of splenic tissue associated with an immune response 6. [radiopaedia.org]
Physical examination was unremarkable except for splenomegaly and skin lesions. Liver function tests were normal; a needle biopsy of the liver (right lobe) showed nonspecific changes. [ncbi.nlm.nih.gov]
It results from increased resistance to blood flow due to any cause. in which it is responsible for ascites, splenomegaly, and the formation of varices. [medicscientist.com]
The sinusoidal ressistance is the most often. [1] Pathological consequences [ ✎ edit | edit source ] Splenomegaly [ ✎ edit | edit source ] Splenomegaly in PH is caused by higher blood pressure in lienal vein. [wikilectures.eu]
- Massive Splenomegaly
Massive splenomegaly (>10 cm below the left subcostal margin)-present in >95 % of patients. Dilated superficial abdominal veins- in15 %. Mild hepatomegaly ( Eggs S. hematobium S. manson Inf. mesentery v. Predom Egypt/ Middle East/ Africa/ S. [gastroenterologybook.com]
Portal hypertension may also occur in massive splenomegaly or AV fistulas due to increased blood flow. The most common cause of portal hypertension is c i r rhos is of liv e r. Portal hypertension is present in more than 60% of cirrhosis patients. [medicscientist.com]
Increased flow volume is a rare cause, although it often contributes to portal hypertension in cirrhosis and in hematologic disorders that cause massive splenomegaly. [merckmanuals.com]
Liver, Gall & Pancreas
- Liver Mass
Improving the prediction of hepatocellular carcinoma in cirrhotic patients with an arterially-enhancing liver mass. Liver Transpl. 2005 Mar. 11(3):281-9. [Medline]. [Guideline] Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. [medscape.com]
Skin
- Skin Lesion
Physical examination was unremarkable except for splenomegaly and skin lesions. Liver function tests were normal; a needle biopsy of the liver (right lobe) showed nonspecific changes. [ncbi.nlm.nih.gov]
Workup
Occlusive Disease Median Arcuate Ligament Syndrome Conclusion Historical Background Mesenteric Venous Thrombosis Chronic MesentericArtery Ischemia Conclusion Introduction Pathophysiology and Anatomy Types of Mesenteric Lschemia Clinical Presentation Workup [books.google.com]
Clinical characteristics are given in Table 1, and all diagnoses were based on standard clinical workup. All patients had clinically stable disease. [link.springer.com]
A black tarry stool on the gloved finger suggests an upper gastrointestinal source, and further workup needs to be pursued. [clevelandclinicmeded.com]
Indeed, esophageal varices are responsible for the main complication of portal hypertension, upper gastrointestinal (GI) hemorrhage (see Etiology and Pathophysiology, Prognosis, Presentation, and Workup ). (See the images below.) [emedicine.medscape.com]
Ultrasound
- Enlargement of the Spleen
Splenomegaly Splenomegaly indicates an enlargement of the spleen usually associated with an overactivity of the spleen, defined hypersplenism, which leads to premature destruction of blood cells. [abdominalkey.com]
Treatment
Hg) on treatment ( P 1 ). [link.springer.com]
World Experience with Endovascular Graft Treatment of rAAAS Advantages of Endovascular Treatment of rAAAs Discussion Incidence Surgical Management Methods for Endovascular Graft Repair Surveillance Considerations for Isolated Iliac Aneurysms Treated [books.google.com]
Endovascular treatment has thus currently emerged as a minimally invasive reliable treatment option in such individuals. 2 APFs often have a good prognosis, due to the minimal effects of a single APF and the effectiveness of current treatments. [elsevier.es]
Prognosis
On this page: Article: Pathology Radiographic features Treatment and prognosis Differential diagnosis Related articles References Images: Cases and figures Pathology Causes can be split by their relation to the hepatic sinusoids: presinusoidal portal [radiopaedia.org]
The prognosis is generally good depending on the management of bleeding varices. [thieme-connect.com]
Liver is a comprehensive book that discusses all aspects of diseases ranging from epidemiology to prognosis. [books.google.es]
Prognosis and Treatment Prognosis is critically dependent on liver function. Liver failure is often the prime cause or a significant associated factor in mortality. [hepatitiscentral.com]
Stage IV requires the presence of portal vein thrombosis, which has been associated with a poor prognosis. The clinical utility of this staging system needs to be validated in further studies. [gastroenterologybook.com]
Etiology
Although the etiology is obscure, certain immunologic abnormalities seem to play an etiologic role in Japanese patients, and the incidence has markedly declined in recent years in Japan, indirectly suggesting a role of infection. [thieme-connect.com]
We conducted this prospective study to elucidate the prevalence and etiology of... [connection.ebscohost.com]
In our series, the response in children with sinusoidal etiologies though late, yet was statistically significant. [tropicalgastro.com]
Etiology Most common etiologies in Tanzania for portal HTN are schistosomal portal fibrosis and cirrhosis: other causes include splenic and portal vein thrombosis. [cardiokh.com]
The most common etiology of portal hypertension is due to liver cirrhosis which accounts for 90% of the cases in the United States[ 2 ]. [wjgnet.com]
Epidemiology
Liver is a comprehensive book that discusses all aspects of diseases ranging from epidemiology to prognosis. [books.google.es]
Epidemiology : C ommon in Asia- accounts for20 % of all portal hypertension in India. [gastroenterologybook.com]
Development and Imaging Configurations Intravascular Ultrasound Imaging Techniques Clinical Utility of Intravascular Ultrasound Normal Blood Flow Arterial Stenoses Stenosis as Part of a Larger Arterial Circuit Bypass Grafts Conclusions Historical Perspective Epidemiology [books.google.com]
Background and Epidemiology Usually a consequence of liver cirrhosis but can occasionally have other causes. In the presence of portal hypertension, the risk of variceal bleeding can vary from 7% (small) to 30% (large). [dundeemedstudentnotes.wordpress.com]
Prognostic factors in patients with idiopathic portal hypertension: Two Japanese nationwide epidemiological surveys in 1999 and 2005. Hepatol Res. 2012;42(12):1211–1220. 23. Okudaira M, Ohbu M, Okuda K. [dovepress.com]
Pathophysiology
Pathophysiology of NIH Neointimal Hyperplasia as a Response to Injury Interventions to Treat Neointimal Hyperplasia Acknowledgments Introduction Biology of Vessel Formation Therapeutic Angiogenesis Stem cell Therapy Summary and Future Perspective Acknowledgements [books.google.com]
[…] existence of a significant correlation between pulmonary artery plasma epinephrine concentration and cardiac index (r2 = 0.46, p less than 0.01) in patients with presinusoidal portal hypertension suggests that the adrenal medulla could play a role in the pathophysiology [ncbi.nlm.nih.gov]
INTRA-hepatic (post-sinusoidal = veno-occlusive disease, sinusoidal = cirrhosis, pre-sinusoidal = schistomiasis), POST-hepatic (heart failure, constrictive pericarditis, cor pulmonale aka RV enlargement from pulmonary disease) pre-hepatic portal hypertension: pathophysiology [quizlet.com]
"Pathophysiology of Portal Hypertension and Esophageal Varices". International Journal of Hepatology. 2012 : 1–7. doi : 10.1155/2012/895787. PMC 3362051. [en.wikipedia.org]
Prevention
Next Document: Melatonin prevents peritoneal adhesions in rats. [biomedsearch.com]
It also includes a chapter on preventive aspects of hepato-biliary diseases keeping in mind that prevention of diseases is always preferred to cure. One of the unique features of this book is, it has contributors from all over the world. [books.google.es]
What is primary prevention of variceal bleeding? If non-bleeding varices are identified at endoscopy, β-blocker therapy with propranolol (80–160 mg/day) or nadolol is effective in reducing portal venous pressure and preventing variceal bleeding. [brainscape.com]
Literatur Bernard B, Lebrec D, Mathurin P et al. (1997) Beta adrenergic antagonists in the prevention of gastrointestinal rebleeding in patients with cirrhosis: A meta-analysis. [link.springer.com]
Special chapters, such as the Designing Clinical Research in Gastrointestinal Endoscopy, The Prevention of Infection Following Gastrointestinal Endoscopy, Complications of Peptic Ulcer Disease, and Credentialing for Gastrointestinal Endoscopy, help make [books.google.com]