Portal hypertension syndrome

Portal hypertension syndromePORTAL HYPERTENSION SYNDROME - a syndrome characterized by increased pressure in the pool of the portal vein, the expansion of natural portocaval anastomoses, ascites, splenomegaly. There are extrahepatic form of portal hypertension, when the impediment to blood flow is localized in pechenochnyi departments of the portal vein (obstructive) or in neorganic departments hepatic veins (b - nadpochechnaja), intrahepatic (obstruction of blood flow is localized in the liver) and mixed forms of portal hypertension. There is also acute and chronic portal hypertension syndromes. Obstruction of blood flow in the portal vein leads to the expansion of its anastomoses with obstructive form of portal hypertension mainly improve portaportal way of collateral circulation (in the crawl space obstacles), while intra - and nadpochechnoj form portocaval (from the portal vein in the lower and upper hollow): occurs varicose veins of the esophagus and stomach, hemorrhoidal plexus, enlarged superficial veins radiating from the umbilicus (the symptom of Medusa's head). Due to stagnation of blood, increased pressure in the portal vein, and hypoalbuminemia formed ascites, increased spleen. The symptoms for. At an early stage asymptomatic, in later cases, is characterized by the appearance of ascites, enlargement of hemorrhoid and subcutaneous paraumbilical veins (as in "head of Medusa"), the re-emergence of hemorrhoid or profuse esophageal-gastric bleeding; the latter are often the cause of death of patients. The diagnosis is indirectly confirmed by contrast radiography of the esophagus (found varicose his veins). More accurate is the measurement of pressure in the esophageal veins (via esophagoscopy), but often is splenomegalia; with portal hypertension pressure in the spleen (identical to that of the portal vein) increases with 70-150 300 - 600 mm of water. Art. and more. Less with the same purpose, conduct transumbilical portolano-metry. Special x-ray methods splenoportography and transumbilical porteparole - if necessary, allow to specify the level and (presumably) the breach of portal blood flow. The course and prognosis are determined by the nature of the disease, causing portal hypertension, and the accession of complications, the most formidable of which is the esophageal-gastric bleeding. Quick delete a large amount of ascitic fluid and the appointment of high doses of diuretics patients with chronic liver diseases with syndrome of portal hypertension may cause hepatic coma. In the absence of surgical treatment of patients, which saw the esophageal-gastric bleeding, do not live more than 1-1,5 years. The surgical treatment (often overlapping portocaval or splenorenal anastomosis). Patients with portal hypertension is contraindicated exercise..



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