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Portal Hypertension (cont.)

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What are the symptoms of portal hypertension?

When blood cannot easily flow through the liver architecture (from portal vein to sinusoids to hepatic vein to Vena cava), it tries to bypass the portal system, using the systemic venous system to return to the heart. Symptoms of portal hypertension are due to the complications of decreased blood flow through the liver, and from increased pressure within the veins where blood is shunted.

  • Varices describe enlarged veins. Blood meant for the portal system, is diverted to and gathers in other veins as it makes its way to the heart. These varices can occur in the esophagus, stomach, around the umbilicus and in the anus and rectum.
  • Esophageal and gastric varices are at risk for life threatening bleeding and can have signs and symptoms with vomiting blood and blood in the stool. Melena describes black, tarry stool that is the result of upper gastrointestinal bleeding.
  • Ascites describes abnormal fluid collection within the peritoneum (the sac that contains the intestines within the abdominal cavity) and is due to a combination of factors, including increased pressure in the portal system and decrease protein in the body. The liver produces the body's protein and portal hypertension and the underlying liver disease decreases its ability to function.
  • Hepatic encephalopathy is another complication of liver disease, causing confusion and lethargy due to the buildup of waste products and the inability of the liver to adequately filter them.
  • Splenomegaly or enlargement of the spleen. Because of portal hypertension, blood backs up, and this also can trap the components of blood (red blood cells, white blood cells and platelets) within the spleen causing anemia and thrombocytopenia (low platelet count in the bloodstream).
  • Decreased white blood cell counts increase the risk of general infection. Spontaneous bacterial peritonitis is an infection within the peritoneal sac within the abdomen, and is seen as a consequence of long standing portal hypertension.
Medically Reviewed by a Doctor on 9/6/2016



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