Portal Hypertension
Portal Hypertension is a topic covered in the Pocket ICU Management.
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-- The first section of this topic is shown below --
First Things First (assess for & address the following)
- Diagnosis of underlying liver disease
- Portal hypertension is a result of cirrhosis or portal vein thrombosis (PVT)
- Presinusoidal, sinusoidal, and postsinusoidal cirrhosis
- Portal hypertension is a result of cirrhosis or portal vein thrombosis (PVT)
- Estimation of functional hepatic reserve
- Useful in predicting operative outcomes and prognosis in patients not undergoing operation
- Child-Pugh classification
- MELD score
- Useful in predicting operative outcomes and prognosis in patients not undergoing operation
- Definition of portal venous anatomy and hepatic hemodynamics
- Has pt had any manipulation of the portal venous system?
- TIPS
- Surgical porto-systemic shunts
- How high is the pressure of the portal vein?
- Has pt had any manipulation of the portal venous system?
- Identify site of upper GI hemorrhage (if present)
- Esophagogastric variceal bleeding is the most life-threatening complication of portal hypertension (responsible for 1/3 deaths in cirrhotic patients).
- Variceal bleeding is worse in pts with cirrhosis than those with more normal hepatic function (PCT).
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First Things First (assess for & address the following)
- Diagnosis of underlying liver disease
- Portal hypertension is a result of cirrhosis or portal vein thrombosis (PVT)
- Presinusoidal, sinusoidal, and postsinusoidal cirrhosis
- Portal hypertension is a result of cirrhosis or portal vein thrombosis (PVT)
- Estimation of functional hepatic reserve
- Useful in predicting operative outcomes and prognosis in patients not undergoing operation
- Child-Pugh classification
- MELD score
- Useful in predicting operative outcomes and prognosis in patients not undergoing operation
- Definition of portal venous anatomy and hepatic hemodynamics
- Has pt had any manipulation of the portal venous system?
- TIPS
- Surgical porto-systemic shunts
- How high is the pressure of the portal vein?
- Has pt had any manipulation of the portal venous system?
- Identify site of upper GI hemorrhage (if present)
- Esophagogastric variceal bleeding is the most life-threatening complication of portal hypertension (responsible for 1/3 deaths in cirrhotic patients).
- Variceal bleeding is worse in pts with cirrhosis than those with more normal hepatic function (PCT).
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