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English Wikipedia
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Current management of the complications of portal hypertension: variceal bleeding and ascites Dib N; Oberti F; Cales PCMAJ 2006[May]; 174 (10): 1433-43Portal hypertension is one of the main consequences of cirrhosis. It results from a combination of increased intrahepatic vascular resistance and increased blood flow through the portal venous system. The condition leads to the formation of portosystemic collateral veins. Esophagogastric varices have the greatest clinical impact, with a risk of bleeding as high as 30% within 2 years of medium or large varices developing. Ascites, another important complication of advanced cirrhosis and severe portal hypertension, is sometimes refractory to treatment and is complicated by spontaneous bacterial peritonitis and hepatorenal syndrome. We describe the pathophysiology of portal hypertension and the current management of its complications, with emphasis on the prophylaxis and treatment of variceal bleeding and ascites.|Algorithms[MESH]|Anti-Bacterial Agents/administration & dosage[MESH]|Ascites/etiology/physiopathology[MESH]|Collateral Circulation[MESH]|Diuretics/therapeutic use[MESH]|Endoscopy, Gastrointestinal[MESH]|Esophageal and Gastric Varices/etiology/prevention & control/*therapy[MESH]|Gastrointestinal Hemorrhage/prevention & control[MESH]|Hepatorenal Syndrome/physiopathology/therapy[MESH]|Hormones/therapeutic use[MESH]|Hypertension, Portal/*complications/physiopathology[MESH]|Liver Cirrhosis/physiopathology[MESH]|Lypressin/analogs & derivatives/therapeutic use[MESH]|Peritonitis/drug therapy[MESH]|Portasystemic Shunt, Transjugular Intrahepatic[MESH]|Sclerotherapy[MESH]|Secondary Prevention[MESH]|Somatostatin/therapeutic use[MESH]|Spironolactone/therapeutic use[MESH]|Terlipressin[MESH]|Vascular Resistance[MESH]|Vasoconstrictor Agents/therapeutic use[MESH]|Vasodilation[MESH]|Vasopressins/therapeutic use[MESH] |
