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Pathophysiology of portal hypertension.
Clin Liver Dis. 1997 May; 1(1):1-12.CL

Abstract

Portal hypertension is a common clinical syndrome associated with chronic liver diseases, and is characterized by a pathological increase in portal pressure that leads to the formation of portosystemic collaterals resulting in shunting of portal blood into the systemic circulation. The increase in portal pressure is due to an increase in vascular resistance and an elevated portal blood flow. The site of increased resistance is variable, and dependent upon the disease process. The site of relative obstruction may be prehepatic, hepatic, or posthepatic. There are several intrahepatic lesions that lead to increased resistance. Some of these lesions are irreversible, like fibrosis, regenerating nodules, and capillarization of the space of Disse; however, there is a functional component, increased vascular tone, which contributes to increased intrahepatic resistance and is potentially reversible. Another important factor contributing to the increased portal pressure is elevated portal blood flow. Peripheral vasodilatation initiates the classical profile of decreased systemic resistance, expanded plasma volume, elevated splanchnic blood flow, and elevated cardiac index, which characterize the hyperdynamic circulatory state. This hyperdynamic circulation is responsible for various complications of portal hypertension.

Authors+Show Affiliations

Veteran's Affairs Medical Center, West Haven, Connecticut 06516, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15562664

Citation

Gupta, T K., et al. "Pathophysiology of Portal Hypertension." Clinics in Liver Disease, vol. 1, no. 1, 1997, pp. 1-12.
Gupta TK, Chen L, Groszmann RJ. Pathophysiology of portal hypertension. Clin Liver Dis. 1997;1(1):1-12.
Gupta, T. K., Chen, L., & Groszmann, R. J. (1997). Pathophysiology of portal hypertension. Clinics in Liver Disease, 1(1), 1-12.
Gupta TK, Chen L, Groszmann RJ. Pathophysiology of Portal Hypertension. Clin Liver Dis. 1997;1(1):1-12. PubMed PMID: 15562664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pathophysiology of portal hypertension. AU - Gupta,T K, AU - Chen,L, AU - Groszmann,R J, PY - 1997/5/1/pubmed PY - 2005/3/25/medline PY - 1997/5/1/entrez SP - 1 EP - 12 JF - Clinics in liver disease JO - Clin Liver Dis VL - 1 IS - 1 N2 - Portal hypertension is a common clinical syndrome associated with chronic liver diseases, and is characterized by a pathological increase in portal pressure that leads to the formation of portosystemic collaterals resulting in shunting of portal blood into the systemic circulation. The increase in portal pressure is due to an increase in vascular resistance and an elevated portal blood flow. The site of increased resistance is variable, and dependent upon the disease process. The site of relative obstruction may be prehepatic, hepatic, or posthepatic. There are several intrahepatic lesions that lead to increased resistance. Some of these lesions are irreversible, like fibrosis, regenerating nodules, and capillarization of the space of Disse; however, there is a functional component, increased vascular tone, which contributes to increased intrahepatic resistance and is potentially reversible. Another important factor contributing to the increased portal pressure is elevated portal blood flow. Peripheral vasodilatation initiates the classical profile of decreased systemic resistance, expanded plasma volume, elevated splanchnic blood flow, and elevated cardiac index, which characterize the hyperdynamic circulatory state. This hyperdynamic circulation is responsible for various complications of portal hypertension. SN - 1089-3261 UR - https://www.unboundmedicine.com/medline/citation/15562664/Pathophysiology_of_portal_hypertension_ DB - PRIME DP - Unbound Medicine ER -