Liver and intrahepatic bile ducts - nontumor
Vascular disorders
Portal hypertension

Author: Komal Arora, M.D. (see Authors page)

Revised: 9 November 2017, last major update May 2012

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Portal hypertension[TI] liver[TI] free full text[sb]

Table of Contents
Definition / general
Cite this page: Arora, K. Portal hypertension. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/liverportalhypertension.html. Accessed December 13th, 2017.
Definition / general
  • Causes are pre, intra and posthepatic
  • Prehepatic: obstructive thrombosis and narrowing of portal vein before it ramifies in the liver, shunting of blood into splenic vein via splenomegaly
  • Intrahepatic: usually cirrhosis, due to increased resistance to portal flow at level of sinusoids and compression of central veins by perivenular fibrosis and expansive parenchymal nodules; also connections between arterial and portal systems raise portal venous pressure
  • Posthepatic: congestive heart failure, constrictive pericarditis, hepatic vein outflow obstruction; may be due to myeloproliferative disorders with hypercoagulability, peritonitis, chronic exposure to arsenic
  • Rare causes: schistosomiasis, massive fatty change, sarcoidosis, miliary tuberculosis, nodular regenerative hyperplasia
  • Complications: ascites, portosystemic venous shunts (hemorrhoidal veins, cardioesophageal junction and esophageal varices, retroperitoneum, falciform ligament of liver [dilated periumbilical and abdominal wall collaterals cause caput medusae on abdominal / thorax]), congestive splenomegaly, hepatic encephalopathy