Document Detail


Portal hypertension.
MedLine Citation:
PMID:  15818152     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Report on significant advances in the pathophysiology, diagnosis, and management of the complications of portal hypertension that have occurred in the last year. RECENT FINDINGS: The specific areas reviewed refer to experimental studies aimed at modifying the factors that lead to portal hypertension (increased intrahepatic vascular resistance and splanchnic vasodilatation) and recent advances in the diagnosis and management of the complications of portal hypertension. The specific complications reviewed in this paper are varices and variceal bleeding (primary prophylaxis, treatment of the acute episode, and secondary prophylaxis), ascites and some of its complications (hyponatremia, hepatic hydrothorax), hepatorenal syndrome, spontaneous bacterial peritonitis, and hepatic encephalopathy. SUMMARY: Important studies, mostly prospective, regarding the management of the complications of portal hypertension are reviewed, including trials that demonstrate the value of the hepatic venous pressure gradient in predicting these complications, a trial of beta-blockers in patients with small varices, a randomized trial of transjugular intrahepatic portosystemic shunt using covered stents and another pilot study using this shunt in the treatment of hepatorenal syndrome, a trial of antibiotic prophylaxis in preventing early variceal rebleeding, and a trial of synbiotic therapy in hepatic encephalopathy. These trials will contribute to advancing the practice of hepatology and defining future research areas.
Authors:
Guadalupe Garcia-Tsao
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in gastroenterology     Volume:  21     ISSN:  0267-1379     ISO Abbreviation:  Curr. Opin. Gastroenterol.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-08     Completed Date:  2005-08-03     Revised Date:  2006-05-09    
Medline Journal Info:
Nlm Unique ID:  8506887     Medline TA:  Curr Opin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  313-22     Citation Subset:  IM    
Affiliation:
Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT 06510, USA. guadalupe.garcia-tsao@yale.edu
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MeSH Terms
Descriptor/Qualifier:
Humans
Hypertension, Portal* / complications,  physiopathology,  therapy

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