RT Journal Article
SR Electronic
T1 Current management of the complications of portal hypertension: variceal bleeding and ascites
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1433
OP 1443
DO 10.1503/cmaj.051700
VO 174
IS 10
A1 Nina Dib
A1 Frédéric Oberti
A1 Paul Calès
YR 2006
UL http://www.cmaj.ca/content/174/10/1433.abstract
AB Portal hypertension is one of the main consequences of cirrhosis. It results from a combination of increased intrahepatic vascular resistance and increased blood flow through the portal venous system. The condition leads to the formation of portosystemic collateral veins. Esophagogastric varices have the greatest clinical impact, with a risk of bleeding as high as 30% within 2 years of medium or large varices developing. Ascites, another important complication of advanced cirrhosis and severe portal hypertension, is sometimes refractory to treatment and is complicated by spontaneous bacterial peritonitis and hepatorenal syndrome. We describe the pathophysiology of portal hypertension and the current management of its complications, with emphasis on the prophylaxis and treatment of variceal bleeding and ascites.