Description

Portal hypertension is a condition characterized by increased blood pressure within the portal venous system, which comprises the portal vein and its branches. The portal vein carries blood from the digestive organs, such as the stomach, intestines, and spleen, to the liver. In portal hypertension, the normal flow of blood through the portal vein is obstructed or impeded, leading to an elevation in pressure. The increase in pressure occurs due to resistance to blood flow within the liver or obstruction of blood flow in the portal vein or its tributaries. The most common cause of portal hypertension is cirrhosis, a progressive liver disease characterized by extensive scarring and impaired liver function. However, other liver diseases and conditions can also contribute to the development of portal hypertension. Causes of portal hypertension Prehepatic Prehepatic causes of portal hypertension refer to conditions that result in increased blood pressure in the portal vein before it reaches the liver. These conditions usually affect the portal vein or its tributaries, leading to the obstruction or narrowing of blood flow. Prehepatic causes of portal hypertension include: Portal vein thrombosis: This occurs when a blood clot forms in the portal vein or its branches, obstructing blood flow and increasing pressure in the portal system. Causes of portal vein thrombosis include hypercoagulable disorders, liver cirrhosis, abdominal infections, trauma, and certain abdominal surgeries. Splenic vein thrombosis: Thrombosis or blood clotting in the splenic vein, which drains blood from the spleen, can lead to increased pressure in the portal system. Splenic vein thrombosis can occur due to conditions such as pancreatitis, pancreatic tumors, and cirrhosis. Splenic vein stenosis: Narrowing or constriction of the splenic vein can restrict blood flow and cause portal hypertension. This condition may be congenital (present at birth) or acquired due to conditions like chronic pancreatitis or previous abdominal surgeries. Congenital portal vein malformations: Rare congenital abnormalities can affect the structure of the portal vein, such as portal vein agenesis (absence of the portal vein), portal vein hypoplasia (underdevelopment of the portal vein), or portal vein aneurysms (abnormal dilation of the portal vein). Arteriovenous malformations: Abnormal connections between arteries and veins in the abdominal area can bypass the liver and lead to increased blood flow in the portal system, causing portal hypertension. These malformations can be congenital or acquired. Vascular compression: External compression on the portal vein by neighboring structures, such as tumors or enlarged lymph nodes, can impede blood flow and result in portal hypertension.

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