K U L I A H TATALAKSANA PERDARAHAN HIPERTENSI PORTAL PADA ANAK Bagus Setyoboedi, Sjamsul Arief,Boerhan Hidajat Divisi Hepatologi Bagian Ilmu Kesehatan Anak FK Unair RSU Dr. Soetomo Surabaya. DOWNLOAD PDF. Description Download Hipertensi Portal Comments. Report 'Hipertensi Portal' Please fill this form, we will try to respond as soon as possible. Submit Close. Share & Embed 'Hipertensi Portal' Please copy and paste this embed script to where you want to embed. Embed Script. Size (px) URL.

Portal hypertensionThe portal vein and its tributariesSymptomsAscitesCausesSplenic vein thrombosis, stenosis of portal veinUltrasonographyTreatmentPortosystemic shunts, Nonselective beta-blockersPortal hypertension is (high blood pressure) in the – made up of the and its branches, that drain from most of the intestine to the. Portal hypertension is defined as a. (a form of chronic liver failure) is the most common cause of portal hypertension; other, less frequent causes are therefore grouped as non-cirrhotic portal hypertension. When it becomes severe enough to cause symptoms or complications, treatment may be given to decrease portal hypertension itself or to manage its complications. (free fluid in the ),.

Abdominal pain or tenderness (when bacteria infect the ascites, as in ). Increased spleen size , which may lead to lower platelet counts. ((citation needed. Swollen veins on the anterior abdominal wall (sometimes referred to as )In addition, a widened (dilated) portal vein as seen on a or may raise the suspicion about portal hypertension. A of 13 mm is widely used in this regard, but the diameter is often larger than this is in normal individuals as well.

Causes The causes for portal hypertension are classified as originating in the portal venous system before it reaches the liver ( prehepatic causes), within the liver ( intrahepatic) or between the liver and the heart (post-hepatic). The most common cause is cirrhosis (chronic liver failure).

Other causes include: Prehepatic causes. thrombosis. (increased portal blood flow)Hepatic causes. of any. For example:. Fibrosis of.

Granulomatous or infiltrative liver diseases (Gaucher, mucopolysaccharidosis, sarcoidosis, lymphoproliferative malignancies, amyloid deposition.). Toxicity (from arsenic, copper, vinyl chloride monomers, mineral oil, vitamin A, azathioprine, dacarbazine, methotrexate, amiodarone etc.). Viral hepatitis.

Veno-occlusive diseasePosthepatic causes. Inferior vena cava obstruction., e.g. From.

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also known as hepatic vein thrombosisPathophysiology. Portal hypertension due to cirrhosis resulting in revascularization of the umbilical vein(US) is the first-line imaging technique for the diagnosis and follow-up of portal hypertension because it is non-invasive, low-cost and can be performed on-site.A dilated portal vein (diameter of greater than 13 or 15 mm) is a sign of portal hypertension, with a estimated at 12.5% or 40%. On, a slow velocity of. Fluoroscopic image of transjugular intrahepatic portosystemic shunt (TIPS)Selective shunts select non-intestinal flow to be shunted to the systemic venous drainage while leaving the intestinal venous drainage to continue to pass through the liver. The most well known of this type is the splenorenal. This connects the splenic vein to the left renal vein thus reducing portal system pressure while minimizing any encephalopathy.

In an H-shunt, which could be mesocaval (from the superior mesenteric vein to the inferior vena cava) or could be, portocaval (from the to the inferior ) a graft, either synthetic or the preferred vein harvested from elsewhere on the patient's body, is connected between the superior and the inferior vena cava. The size of this shunt will determine how selective it is.With the advent of, portosystemic shunts are less performed.

TIPS has the advantage of being easier to perform and doesn't disrupt the liver's vascularity. Prevention of bleeding Both pharmacological (non-specific β-blockers, nitrate isosorbide mononitrate, vasopressin such as ) and endoscopic (banding ligation) treatment have similar results. TIPS is effective at reducing the rate of rebleeding.The management of active variceal bleeding includes administering vasoactive drugs (somatostatin, octreotide), endoscopic banding ligation, balloon tamponade and TIPS. Ascites The management of needs to be gradual to avoid sudden changes in systemic volume status which can precipitate, and death.

The management includes, ,. Hepatic encephalopathy A treatment plan may involve, and use of antibiotics such as, and the. Restriction of dietary protein was recommended but this is now refuted by a clinical trial which shows no benefit. Instead, the maintenance of adequate nutrition is now advocated. References.