PORTAL HYPERTENSION

• Portal HT- portal venous pressure > 5 mm Hg.
• Higher pressures (8-10 mm Hg) are required to stimulate portosystemic collateralization
• Etiology

Ä  Prehepatic

§  Portal vein thrombosis (MC cause of prehepatic portal HT)

§  Splenic vein thrombosis (a.k.a. Lt. sided portal HT)

§  Massive splenomegaly (Banti's syndrome)

Ä  Hepatic

§  Presinusoidal

·         Schistosomiasis (MC cause of intrahepatic presinusoidal obstr.)

·         Congenital hepatic fibrosis

§  Sinusoidal

·         Cirrhosis—many causes

·         Alcoholic hepatitis

§  Postsinusoidal

·         Hepatic sinusoidal obstruction (venoocclusive syndrome)

·         Alcoholic cirrhosis

Ä  Posthepatic

§  Budd-Chiari syndrome

§  Inferior vena caval webs

§  Cardiac causes

·         Restrictive cardiomyopathy

·         Constrictive pericarditis

·         Severe congestive heart failure