| Portal hypertension. | |
| | |
MedLine Citation:
|
PMID: 2657268 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Portal hypertension is a frequent syndrome characterized by a chronic increase in portal venous pressure and by the formation of portal-systemic collaterals. Its main consequence is massive bleeding from ruptured esophageal and gastric varices. Bleeding is promoted by increased portal and variceal pressure, and is favored by dilatation of the varices. The evaluation of the portal hypertensive patient should include the assessment of portal vein patency by ultrasonography, endoscopic evaluation of the presence, size, and extent of esophageal varices, and hemodynamic studies with measurements of portal pressure and of portal-collateral blood flow. The preferred techniques are hepatic vein catheterization and measurement of azygos blood flow. Endoscopic measurements of variceal pressure and estimations of portal blood velocity by the Doppler technique have recently been introduced, but are still research procedures. Acute variceal hemorrhage should be treated under intensive care. Specific therapy to arrest variceal bleeding includes balloon tamponade, vasopressin, somatostatin, sclerotherapy, and emergency surgery. Treatment of portal hypertension is aimed at preventing variceal hemorrhage and bleeding-related deaths. Pharmacologic prophylaxis is based on the use of drugs that cause a sustained reduction in portal pressure; most studies have used propranolol. Surgery and endoscopic sclerotherapy can also be used to prevent rebleeding. |
| | |
Authors:
|
J Bosch; M Navasa; J C Garcia-Pagán; A M DeLacy; J Rodés |
Related Documents
:
|
1918848 - Effect of intraportal nitroglycerin on portosystemic hemodynamics in patients with cirr... 2328958 - Hemodynamic effects of glucagon in portal hypertension. 14767978 - Targeting portal pressure measurements: a critical reappraisal. 10383838 - Reduction in vascular responsiveness to adrenomedullin during sepsis. 21858788 - Putting cells under pressure: a simple and efficient way to enhance the productivity of... 1510638 - Cardiovascular responses to positive pressure breathing using the tactical life support... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
|
Title: The Medical clinics of North America Volume: 73 ISSN: 0025-7125 ISO Abbreviation: Med. Clin. North Am. Publication Date: 1989 Jul |
Date Detail:
|
Created Date: 1989-07-07 Completed Date: 1989-07-07 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 2985236R Medline TA: Med Clin North Am Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 931-53 Citation Subset: AIM; IM |
Affiliation:
|
University of Barcelona School of Medicine, Spain. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Disease Collateral Circulation Emergencies Esophageal and Gastric Varices / complications, etiology Gastrointestinal Hemorrhage / etiology, prevention & control, therapy Humans Hypertension, Portal* / complications, diagnosis, etiology, therapy Methods Portal System Rupture, Spontaneous Venous Pressure |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Primary biliary cirrhosis.
Next Document: Fulminant hepatic failure.