Etiology of Portal Hypertension

 We will be talking about the Etiology of Portal Hypertension and Site of Increased Resistance

Cirrhosis :

Site of Increased Resistance : Intrahepatic sinusoidal

Liver Disease : Present

Cirrhosis of Liver is a late stage chronic liver disease where healthy Liver Tissue is replaced permanently by scar tissue / fibrosis and regenerative nodules impairing vital liver functions like filtering of toxins and producing proteins.

Common Causes of Cirrhosis :

Chronic Alcohol Use

Viral Hepatitis

Fatty Liver Disease/ Metabolic Dysfunction Associated Steatotic Liver Disease / MASLD and its inflammatory form MASH are linked to Obesity and Diabetes.

Auto immune and Genetic Disorders like Auto immune Hepatitis, Primary Biliary Cholangitis , Haemochromatosis ( Iron Overload ) And Wilsons Disease ( Copper Accumulation )

Symptoms : 

Persistent Fatigue & Weakness

Jaundice Yellowing of Eyes & Skin

Ascites : Fluid build up in the abdomen and swelling of legs due to hypo proteinemia

Easy bruising , frequent bleeding or nse bleeds.

Mental Confusion & Problems due to Hepatic Encephalopathy.

Diagnosis :

Blood Tests ;/ Liver function Tests

Imaging Studies : Ultrasound / MRI or MRElastography

Sometimes Liver Biopsy

Management :

Existing scar tissue cannot be replaced

Manage underlying Cause : Antiviral Therapy , Weight Management,

Alcohol Cessation

Medications to control Portal Hypertension like Spironolactone & Diuretics