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Portal Hypertension (Pathophysiology (Sites of collaterals/varices (Rectum…
Portal Hypertension
Pathophysiology
Following liver injury and fibrogenesis e.g. due to cirrhosis, the contraction of activated myofibroblasts contributes to increased resistance to blood flow
This leads to portal hypertension - splanchnic vasodilation - drop in BP - increased cardiac output to compensate for BP - salt/water retention to increase blood volume and compensate
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Microvasculature of the gut becomes congested and gives rise to portal hypertensive gastropathies and colopathies
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Key points
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Normal pressure is 5-8mmHg with only a small gradient across the liver to the hepatic vein, in which blood is returned to the heart via the inferior vena cava