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Pathophysiology of Portal Hypertension
- Source :
- The Liver
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- Portal hypertension is a common clinical syndrome associated with chronic liver diseases, and is characterized by a pathological increase in portal pressure that leads to the formation of portosystemic collaterals resulting in shunting of portal blood into the systemic circulation. The increase in portal pressure is due to an increase in vascular resistance and an elevated portal blood flow. The site of increased resistance is variable, and dependent upon the disease process. The site of relative obstruction may be prehepatic, hepatic, or posthepatic. There are several intrahepatic lesions that lead to increased resistance. Some of these lesions are irreversible, like fibrosis, regenerating nodules, and capillarization of the space of Disse; however, there is a functional component, increased vascular tone, which contributes to increased intrahepatic resistance and is potentially reversible. Another important factor contributing to the increased portal pressure is elevated portal blood flow. Peripheral vasodilatation initiates the classical profile of decreased systemic resistance, expanded plasma volume, elevated splanchnic blood flow, and elevated cardiac index, which characterize the hyperdynamic circulatory state. This hyperdynamic circulation is responsible for various complications of portal hypertension.
- Subjects :
- Liver Cirrhosis
medicine.medical_specialty
Alcoholic liver disease
Pathology
Cirrhosis
Portal venous pressure
Encephalopathy
Collateral Circulation
Esophageal and Gastric Varices
Article
Liver disease
Internal medicine
Hypertension, Portal
Ascites
Hepatic Stellate Cells
medicine
Humans
Splanchnic Circulation
Plasma Volume
Neovascularization, Pathologic
Hepatology
business.industry
Endothelial Cells
medicine.disease
Vasodilation
Vasoconstriction
Hyperdynamic circulation
Cardiology
Portal hypertension
Vascular Resistance
medicine.symptom
Gastrointestinal Hemorrhage
business
Liver Circulation
Subjects
Details
- ISSN :
- 10893261
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- Clinics in Liver Disease
- Accession number :
- edsair.doi.dedup.....1a8dc56d848bcaa914665f43cd7df41a