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• W1590187536 startingPage "152" @default.
• W1590187536 abstract "Thrombosis of the hepatic artery results in hepatic infarction, the latter also resulting from shock. Hepatic arterial thrombosis is a complication of liver transplantation. Portal vein thrombosis is often associated with prothrombotic conditions, and occurs without cirrhosis, with cirrhosis and after liver transplantation. Portal vein thrombosis is a cause of non-cirrhotic portal hypertension. Portal hypertension develops in association with increasing hepatic fibrosis, and increased splanchnic venous flow, and results in a collateral circulation and raised portal pressure. There is a reversible component to the increased intrahepatic resistance. Oesophagogastric varices, which can cause bleeding, are part of the collateral circulation. The hepatic venous pressure gradient (HVPG), reflects portal pressure in sinusoidal and postsinusoidal causes of portal hypertension and is normal with presinusoidal causes. HVPG is prognostic for the development of complications and mortality associated with cirrhosis. Prevention of first bleeding from varices is undertaken with non-selective beta blockers or endoscopic ligation; secondary prevention is best with both therapies combined. Acute variceal bleeding is best treated with combined vasoactive drugs and endotherapy together with antibiotics. Failures of therapy should be treated with transjugular intrahepatic stent shunt (TIPS) or adhesive glue and as a temporary measure with balloon or stent tamponade. Hepatic venous outflow obstruction is most commonly caused by thrombosis in the hepatic veins. Constrictive pericarditis must be excluded. Thrombosis is often associated with thrombophilic conditions. Anticoagulation, venoplasty and TIPS resolve most cases; sometimes liver transplantation is needed. Hypoxic hepatitis is seen with shock and heart failure." @default.
• W1590187536 created "2016-06-24" @default.
• W1590187536 creator A5073613780 @default.
• W1590187536 date "2011-04-25" @default.
• W1590187536 modified "2023-09-24" @default.
• W1590187536 title "The Hepatic Artery, Portal Venous System and Portal Hypertension: The Hepatic Veins and Liver in Circulatory Failure" @default.
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