short presentation on pediatric portal hypertention

1. PORTAL HYPERTENTION
Ajith
Gr-4

2. • NORMAL RANGE OF PORTAL VENOUS PRESSURE (5-10)mm of hg.
• PORTAL HYPERTENTION IS DEFINED AS THE ELEVATION OF THIS
PRESSURE GRADIENT TO VALUES ABOVE (10-12)mm of hg.
• PHT: Is the pathological increase in the portal pressure in which the
pressure gradient b/w the portal vein and IVC is increased above the
upper limit of 10mm of hg.
• PPG>10mm hg -VARICES
• PPG>12mmhg –VARICEAL BLEEDING,ASCITES

5. ETIOLOGY
• PRE HEPATIC
• INTRA HEPATIC
• POST HEPATIC

6. • PRE HEPATIC-Caused by obstruction of blood flow at level of portal vein.
• Ex: conginetal atresia , extrinsic compression , thrombosis( portal, superior
mesenteric , splenic vein ) , cirrhosis .
• INTRA HEPATIC
• POST HEPATIC-caused by obstruction of blood flow at the level of hepatic vein.
• Ex: budd chiari syndrome ,chronic heart failure ,constrictive pericarditis.

11. DIAGNOSIS
• CLINICAL
• UPPER GI ENDOSCOPY
• US/DOPPLER

12. CLINICAL FEATURES
• GROWTH RETARDATION
• PORTO PULMONARY HYPERTENTION
• HEPATO RENAL SYNDROME
• HEPATO PULMONARY SYNDROME

13. COMPLICATIONS
• UPPER GI BLEEDING(VARICEL)
• ASCITES
• HEPATIC ENCEPHALOPATHY

14. TREATMENT
• PHARMACOLOGICAL: BETA BLOCKERS ,NITRATES(PREVENTION)
• TX: VASOPRESSIN, SOMATOSTATIN , OCTREOTIDE
• ENDOSCOPY: ENDOSCOPIC SCLEROTHERAPY , ENDOSCOPIC VARICEAL
LIGATION
• BALLOON TAMPONADE
• TIPS: TRANS JUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT
• SURGICAL: LIVER TRANSPLANT , SHUNTS, DEVASCULARIZATION

15. THANK YOU