Portal Hypertension
Portal hypertension is high blood pressure of the portal vein in the abdomen. The portal vein collects nutrient-rich blood from the intestines and carries it to the liver. The liver cleans the blood for your body to use.
The increased pressure caused by portal hypertension makes it is harder for the blood from the liver to flow through the portal vein to travel back to the heart. This means it has to use smaller veins in the esophagus, stomach and intestines. The body also forms new vessels for the blood to flow through. These smaller and newly formed veins may be much weaker than the portal vein and may swell up and burst under the added pressure, causing bleeding.
What are the symptoms of portal hypertension?
Having a higher than normal pressure inside the portal vein can lead to a number of related symptoms and complications. These include:
- Enlarged liver
- Varicose veins of the esophagus and stomach
- Internal hemorrhoids
- Weight loss from malnutrition
- Ascites, or fluid buildup in the abdomen.
What causes portal hypertension?
These are the most common cause of portal hypertension:
- Cirrhosis, or scarring of the liver. This blocks the blood flow in the liver and leads to portal hypertension. Learn more about cirrhosis.
- Clotting of the portal vein
- Clotting of the veins in the liver.
How is portal hypertension diagnosed?
Unfortunately, doctors can’t measure high blood pressure in the portal vein with a cuff as they can regular high blood pressure. Those at risk for or already have cirrhosis will likely do various lab tests, X-rays and endoscopic exams to see if they have portal hypertension.
What is the treatment for portal hypertension?
Portal hypertension is treated in several ways.
- Some patients may be put on beta blockers, or medicines that improve the pressure and decrease the possibility of bleeding. Some patients with esophageal varices because of portal hypertension may receive a special injected medicine into the varices to help stop the bleeding. Other patients with internal bleeding and varices may have bands placed around the varicose veins to stop the bleeding.
- In more severe situations, portal hypertension may be treated with shunting to bypass the reason the portal pressure is increased. This involves putting stents in the portal vein to open it and improve blood flow. Shunting can be done with or without surgery. Surgical shunting can cause more complications than the nonsurgical method.
What are the complications associated with portal hypertension?
The small veins overloaded because of portal hypertension can burst and cause internal bleeding. This usually happens where the esophagus and stomach meet. This complication can cause sudden, explosive vomiting of blood. It can be fatal.
Fluid buildup in the stomach can cause you to feel full quickly, leading to weight loss and malnutrition. The discomfort from carrying all that fluid can also reduce how well you can get around. The changes in blood flow sometimes lead to serious kidney problems.
Portal hypertension is a dangerous condition with severe, life-threatening complications. Call your child’s doctor immediately if you notice any of these symptoms:
- Yellowing of the skin
- Unusually swollen abdomen
- Unexpected weight loss.