Acute Life-Threatening Complications of Portal Hypertension: a Review of Pathophysiology, Incidence, Management, and Cost

Portal hypertension represents a dysfunctional hemodynamic alteration within the portal venous system, usually due to cirrhosis. These altered hemodynamics play a direct role in the development of acute, life-threatening variceal hemorrhage and mark an important pathophysiologic step in the developm...

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Bibliographic Details
Published in:SN comprehensive clinical medicine 2020-09, Vol.2 (9), p.1628-1645
Main Authors: Smith, Robert E., Friedman, Alice D., Murchison, James A., Tanner, S. Blake, Smith, P. Alexander, Dollar, Bradley T.
Format: Article
Language:English
Subjects:
Medicine
Medicine & Public Health
Topical Collection on Medicine
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Summary:Portal hypertension represents a dysfunctional hemodynamic alteration within the portal venous system, usually due to cirrhosis. These altered hemodynamics play a direct role in the development of acute, life-threatening variceal hemorrhage and mark an important pathophysiologic step in the development of other sudden and life-threatening complications such as type 1 hepatorenal syndrome and spontaneous bacterial peritonitis. Many life-saving interventions in these patients are aimed at reducing portal venous pressure. The contribution of portal hypertension to the development of variceal hemorrhage, type 1 hepatorenal syndrome (known also by the name HRS-AKI), and spontaneous bacterial peritonitis in cirrhotic patients is discussed. This article reviews the pathophysiology and incidence of life-threatening complications of cirrhotic portal hypertension, with a discussion of management options and treatment costs.
ISSN:2523-8973
2523-8973
DOI:10.1007/s42399-020-00435-5