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Showing posts from October, 2021

Portal Hypertension in children: approach and evaluation

  PORTAL HYPERTENSION in Children Q1: What is portal hypertension? portal venous pressure > 12 mm Hg    or portal pressure gradient (between IVC and portal vein) >5 mm Hg  Currently, the most commonly used parameter is the Hepatic Venous Pressure Gradient (HVPG) [the difference between the wedged (WHVP) and the free hepatic venous pressures] Pressure = Flow x Resistance (Resistance increases due to active myofibroblast or vascular smooth muscle cells in intrahepatic veins; and overall liver disease;  Flow  increases due to splanchnic arteriolar dilatation by release of endogenous vasodilators) (portal veins start and end as capillaries and no valves; please vide the picture on porto-caval anastomosis sites) Q2: What are the 3 key components of portal hypertension? Splenomegaly Ascites Varix (Esophageal varices/ Gastro-esophageal varices/ Isolated gastric varices/ Rectal varices) Q3: What are the causes of portal hypertension?  [Here is a li...