Prehepatic portal hypertension

Portal hypertension defined as an abnormally high pressure in hepatic PV, which clinically described as a venous pressure gradient of 10 mmHg or more. Based on anatomical location, portal hypertension is classified as prehepatic, intrahepatic and posthepatic. PPH is an rare illness in which augmented portal pressure is triggered by impediment of the portal venous tree before it moves in the liver. Congenital abnormalities, prothrombotic conditions and other causal illnesses that disturb part or all of the vessels of partal venous system are the leading cause of obstruction. The most common cause of PPH is PVT. Symptoms always depend on the beginning and the degree of the thrombosis and the expansion of collateral circulation. In case of acute PVT the typical manifestations of the disease are intestinal congestion and ischemia. The main stream of patients display splenomegaly, but ascites is infrequent. In patients with chronic PVT, the symptoms include gastrointestinal bleeding, splenomegaly and hypersplenism. In cirrhotic patients with PVT, all of the standard manifestations of portal hypertension such as ascites, varices and hepatic encephalopathy are present. The goal of the treatment is to correct the underlying elements, stoppage of thrombosis extension, and attainment of PV patency. It has been reported that in 50% of cases, after 6 months of anticoagulant therapy a complete recanalization of the PV was achieved .Anticoagulant therapy in acute PVT has been shown to be more effective than in chronic PVT. Variceal treatment include, pre-primary prophylaxis: patient with portal hypertension who has not yet developed varices and the aim is to prevent varices; (2) primary prophylaxis: the patient with gastroesophageal varices who has never had bleeding from varices and the aim is to prevent bleeding; (3) secondary prophylaxis: the patient with acute variceal bleeding and the aim is to stop the bleeding and prevent its early and late reccurance. Other treatment options for ascites are TIPS and DSRS.MSc/MAfogorvosangolOrvosbiológia-farmakológiag