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Medicine

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Liver & GIT

Question
2 out of 18
 

In portal hypertension portal pressure is more than …..cm of saline?



A 10
B 20
C 30
D 40

Ans. C 30

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

Basic Pathophysiology

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)

1. Prehepatic

i. Portal vein thrombosis

ii. Splenic vein thrombosis

iii. Massive splenomegaly (Banti's syndrome)

2. Hepatic

a. Presinusoidal

i. Schistosomiasis

ii. Congenital hepatic fibrosis

b. Sinusoidal

i. Cirrhosis—many causes

ii. Alcoholic hepatitis

c. Postsinusoidal

i. Hepatic sinusoidal obstruction (veno-occlusive syndrome)

3. Posthepatic

a. Budd-Chiari syndrome

b. Inferior vena caval webs

c. Cardiac causes

i. Restrictive cardiomyopathy

ii. Constrictive pericarditis

iii. Severe congestive heart failure

Extra Edge:

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

Liver & GIT Flashcard List

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