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Quick Facts

Portal Hypertension


The Manual's Editorial Staff

Last full review/revision Sep 2019| Content last modified Sep 2019
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What is portal hypertension?

The portal vein is the large blood vessel that brings blood from your intestines to your liver.

Hypertension is a medical term for high blood pressure.

So, portal hypertension is high blood pressure in your portal vein.

  • Most people get portal hypertension from cirrhosis (a liver disease in which scar tissue replaces normal liver tissue)

  • Portal hypertension is dangerous because it can lead to bleeding in your stomach and esophagus (the tube that connects your throat to your stomach)

  • Medicine can lower blood pressure in your portal vein

  • You will need emergency treatment if you have bleeding in your stomach and esophagus

Blood Supply of the Liver

Blood Supply of the Liver

What causes portal hypertension?

Portal hypertension is usually caused by:

Cirrhosis is severe liver scarring. The scarring blocks blood flow in the liver and raises the pressure in the blood vessels that go to the liver. You can get cirrhosis from chronic liver diseases such as chronic hepatitis C and alcoholic liver disease.

What are the complications of portal hypertension?

The main complication is:

  • Bleeding

The high blood pressure in the portal vein forces blood into other blood vessels. These other blood vessels include those around your stomach and esophagus (the hollow tube that carries food to your stomach). These blood vessels swell up with blood, which makes them bleed easily. Bleeding from these vessels can be severe and even fatal.

What are the symptoms of portal hypertension?

Portal hypertension itself doesn't cause symptoms, but its effects may cause symptoms:

  • Swelling and a tight feeling in the belly from fluid building up there (ascites)

  • Swollen veins on your belly

If portal hypertension causes bleeding from your stomach and esophagus, you may have:

  • Throwing up blood or black stuff that looks like coffee grounds

  • Dark stools (poop) that look like tar

  • Bleeding from your anus (the opening where stool comes out)

You may also have symptoms of liver failure such as:

How can doctors tell I have portal hypertension?

Doctors suspect portal hypertension if you have:

  • Liver disease, particularly if the liver disease caused cirrhosis

  • Swollen veins on your belly

There aren't any specific tests for portal hypertension, but doctors may do tests on your liver, including:

If you're bleeding, doctors will look down your throat with a flexible scope (endoscope). The scope will let them see exactly where in your esophagus and stomach the bleeding is coming from. They can then treat the bleeding.

How do doctors treat portal hypertension?

Bleeding from the veins of the stomach and esophagus is a medical emergency. Doctors treat this bleeding by:

  • Giving medicines to slow the bleeding

  • Giving blood transfusions

  • Closing off the bleeding veins with rubber bands or clips (using an endoscope)

To prevent bleeding from the veins of the stomach and esophagus, doctors use:

  • Medicines to lower blood pressure

  • Surgery to lower the pressure in the portal vein by redirecting blood so it doesn’t pass through the liver (portosystemic shunting)

  • As a last resort, liver transplant (surgery to remove a failing liver and replace it with a healthy one from a donor)

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