Liver & GIT
In portal hypertension portal pressure is more than …..cm of saline?
The normal pressure in portal vein is 2-5 mmHg or 10-15 cm saline. Q
Portal hypertension is defined as portal pressure > 10mmHg or 30 cm saline. Q
Portal hypertension is present when the wedged hepatic vein pressure is more than 5 mmHg of IVC pressure. Since portal vein don’t have any valve so increase resistance to flow at any point between splanchnic venuleand heart will increase pressure in all vessels on intestinal side of obstruction.
This manifest as varices, splenomegaly and ascites.
Table 308-3 Classification of Portal Hypertension (H-18th Pg-2598)
i. Portal vein thrombosis
ii. Splenic vein thrombosis
iii. Massive splenomegaly (Banti's syndrome)
ii. Congenital hepatic fibrosis
i. Cirrhosis—many causes
ii. Alcoholic hepatitis
i. Hepatic sinusoidal obstruction (veno-occlusive syndrome)
a. Budd-Chiari syndrome
b. Inferior vena caval webs
c. Cardiac causes
i. Restrictive cardiomyopathy
ii. Constrictive pericarditis
iii. Severe congestive heart failure
a. The most common cause of portal hypertension is cirrhosis followed by portal vein obstruction.
b. PHT is present is 70% cases of cirrhosis of liver
c. Cirrhosis is present in 90% cases of PHT