Portal Hypertension

Dr Saeed Al-Shomimi KFHU Khobar

Anatomy ,[object Object],[object Object],[object Object],[object Object]

Blood Supply of the Liver Hepatic Arterial Autoregularity Vasodilatation

Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causes of Portal Hypertension Pre-sinusoidal Sinusoidal Post Sinusoidal BLOOD FLOW LIVER

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Variceal Bleeding ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Initial evaluation & stabilization ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pharmacologic Radiologic shunt TIPSS Surgical Shunt Balloon Tamponade Pharmacologic and endoscopic therapy are the usual 1 st and 2 nd interventions Endoscopic Treatment for Acute Variceal Bleeding

Pharmacologic Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object]

Endoscopic Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object]

sclerotherapy ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],Band Ligation

Pharmacologic versus Endoscopic Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Balloon Temponade ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Tube Positioning and Gastric Balloon Inflation

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gastric and Esophageal Balloon Inflation

TIPS (Transjagular Intrahepatic Portosystemic Shunting) ,[object Object],[object Object],[object Object]

Surgical Therapy ,[object Object]

Prevention of Recurrent Variceal Bleeding

Portosystemic Shunt ,[object Object],[object Object]

1 – Non selective Shunts ,[object Object],[object Object],[object Object],[object Object]

2 – Selective Shunts ,[object Object],[object Object],[object Object],[object Object]

3 – Partial Shunts ,[object Object],[object Object]

Esophagogastric Devascularization ,[object Object],[object Object],[object Object]

Orthotopic Liver Transplantation ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object]

Portal Hypertension

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Portal Hypertension