Portal hypertension
Portal hypertension is a clinical syndrome characterised by pathological increase in portal pressure. Any disease interfering with the portal blood flow may lead to portal hypertension; however, the most common cause is liver cirrhosis. Complications of portal hypertension associated with significant morbidity and mortality include variceal bleeding, ascites, bacterial infection, hepatic encephalopathy and hepatorenal syndrome. Prevention of first variceal bleeding (primary prophylaxis), control of acute bleeding and treatment of a bleeding patient, and prevention of rebleeding (secondary prophylaxis) have all significantly reduced the morbidity and mortality of patients with portal hypertension complications. Primary prevention of oesophageal varices is based on the use of non-selective β-blockers and variceal ligation, whereas acute bleeding is prevented by administration of vasoactive drugs and endoscopic ligation or sclerosation of bleeding oesophageal varices. In case these pharmacological and endoscopic interventions fail, transjugular intrahepatic portosystemic shunt or surgery may be used.
Key words:
hemostasis, endoscopic; hypertension, portal; hypertension, portal, drug therapy; ligation; oesophageal and gastric varices; primary prevention; secondary prevention
OGLASI
