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Portal Hypertension

Portal Hypertension is a topic covered in the Pocket ICU Management.

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Anesthesia Central

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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
  • Estimation of functional hepatic reserve
    • Useful in predicting operative outcomes and prognosis in patients not undergoing operation
      • Child-Pugh classification
      • MELD score
  • 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?
  • 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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Last updated: April 29, 2010

Citation

"Portal Hypertension." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534261/all/Portal_Hypertension.
Portal Hypertension. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534261/all/Portal_Hypertension. Accessed April 23, 2019.
Portal Hypertension. (2010). In Pocket ICU Management. Available from https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534261/all/Portal_Hypertension
Portal Hypertension [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2019 April 23]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534261/all/Portal_Hypertension.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Portal Hypertension ID - 534261 Y1 - 2010/04/29/ BT - Pocket ICU Management UR - https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534261/all/Portal_Hypertension PB - PocketMedicine.com, Inc DB - Anesthesia Central DP - Unbound Medicine ER -