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KMID : 1044720120020010001
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Journal of Lifestyle Medicine
2012 Volume.2 No. 1 p.1 ~ p.10
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Portal Hypertension, Update
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Baik Soon-Koo
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Abstract
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Portal hypertension as a consequence of liver cirrhosis is responsible for its serious complications such as variceal bleeding, ascites and hepatic encephalopathy. Development of portal hypertension would be influenced by changes in resistance and flow at the hepatic vasculature. An increased resistance to portal blood flow in cirrhotic liver induce the portal venous dilatation and congestion of portal venous flow, and lead to the elevated portal pressure. Subsequently, portosystemic collaterals develops for counterbalance the increased resistance to portal blood flow, and induce an increase in venous return to heart, which results in increased portal venous inflow. This hyperdynamic splanchnic and systemic circulation contributes to maintain and aggravate portal hypertension, which can be related with multi-organ failure such as hepatorenal syndrome and cirrhotic cadiomyopathy. Increased intrahepatic resistance results from both vasoconstriction and fibrosis. Vasoconstriction is a reversible and dynamic component, which contribute upwards to 25% of increased resistance. In this report, we reviewed focusing on new concepts of pathophysiology, diagnosis and treatments in portal hypertension and cirrhosis.
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KEYWORD
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Portal hypertension, Hyperdynamic circulation, Hepatic stellate cell, Intrahepatic vascular resistance
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