Portal hypertension can be caused by conditions that block the portal vein (precirrhotic) or damage the liver (cirrhotic). It leads to complications like ascites, esophageal varices, and bleeding. Symptoms include abdominal swelling and pain, bleeding, and fatigue. Treatment focuses on reducing portal pressure through dietary changes, diuretics, banding or sclerotherapy of varices, transjugular intrahepatic portosystemic shunting (TIPS), or surgery in severe cases.
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
A presentation on the pathology and current management (with Especial emphasis on surgical management) of Portal Hypertension; a common complication of liver cirrhosis among other liver diseases. Being a copy of seminar presentation I for the HepatoPancreaticoBiliary Unit of the Division of General Surgery, Ahmadu Belllo University Teaching Hospital, Zaria.
Kindly leave your comment if you found this helpful ;)
Some of the slides, i hide it from my real presentations for my own reference. Download to see all of them.
Cor pulmonale is alteration in the structure and function of the right ventricle (RV) of the heart. The overall five-year survival rate for cor pulmonale complicating COPD is approximately 50%.
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
this presentation includes anatomy physiology function of peritoneum ,also includes cause of peritonitis its severity ,various scoring system investigation and treatment.It includes the recent advancement and latest articles from latest books of surgery.
This presentation gives a fine description about stoma and ostomy. This contains the details regarding types, complications and the advices that you should give to a patient with a stoma.
A presentation on the pathology and current management (with Especial emphasis on surgical management) of Portal Hypertension; a common complication of liver cirrhosis among other liver diseases. Being a copy of seminar presentation I for the HepatoPancreaticoBiliary Unit of the Division of General Surgery, Ahmadu Belllo University Teaching Hospital, Zaria.
Kindly leave your comment if you found this helpful ;)
Some of the slides, i hide it from my real presentations for my own reference. Download to see all of them.
Cor pulmonale is alteration in the structure and function of the right ventricle (RV) of the heart. The overall five-year survival rate for cor pulmonale complicating COPD is approximately 50%.
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
this presentation includes anatomy physiology function of peritoneum ,also includes cause of peritonitis its severity ,various scoring system investigation and treatment.It includes the recent advancement and latest articles from latest books of surgery.
This presentation gives a fine description about stoma and ostomy. This contains the details regarding types, complications and the advices that you should give to a patient with a stoma.
Seminar present the Upper Gastrointestinal Bleeding problems
Edited by : Dr. Inzar Yassen & Dr. Ammar L. Aldwaf
in Hawler Medical Uni. collage of medicine in 14/01/2014
Iraq - Kurdistan - Erbil
PERFORATED PEPTIC ULCER
PERFORATION
DEFINITION
It is the terminology used for perforation of duodenal ulcer or gastric ulcer or stomal ulcer.
Otherwise all clinical features and management are similar.
Perforation is common in duodenal ulcer
Mortality is more in gastric ulcer perforation and perforation in elderly
Approach to patient with upper GIT bleeding
Approach to patient with upper GIT bleeding
Approach to patient with upper GIT bleeding
Approach to patient with upper GIT bleeding
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
4. Causes of portal hypertensio
n
Pre hepati
c
• Congenital portal atresi
a
• Portal vein thrombosi
s
• Phlebitis of portal vei
n
Hepati
c
• Cirrhosi
s
• Chronic hepatiti
s
• Parasitic infections (schistosomiasis
)
Post hepati
c
• Budd-chiari syndrom ( Hepatic venus thrombosis
)
• Constructive pericarditi
s
• Tricuspid valve incompetence
6. Symptoms
Symptoms of portal hypertension include the following:
•
Weakness, tiredness, and malaise
•
Anorexia
•
Sudden and massive bleeding, with or without shock on
presentation
•
Nausea and vomiting
•
Weight loss
•
Abdominal discomfort and pain - Usually felt in the right
hypochondrium or under the right lower ribs (front, side, or back)
and in the epigastrium or the left hypochondrium
•
Jaundice
•
Edema and abdominal swelling
7. •
Pruritus
•
Spontaneous bleeding and easy bruising
•
Symptoms of encephalopathy
•
Impotence and sexual dysfunction
•
H e m a t e m e s i s o r m e l e n a - M a y i n d i c a t e
gastroesophageal variceal bleeding
•
Increasing abdominal girth - May indicate ascites
formation
•
Abdominal pain and fever - May indicate spontaneous
bacterial peritonitis
•
Hematochezia
8. Complications of portal hypertensio
n
ASCITES
• The mechanisms responsible for the development of ascites are
not completely understood. Portal hypertension and the resulting
increase in capillary pressure and obstruction of venous blood
fl
ow
through the damaged liver are contributing factors
.
• The failure of the liver to metabolize aldosterone increases sodium
and water retention by the kidney. Sodium and water retention,
increased intravascular
fl
uid volume, and decreased synthesis of
albumin by the damaged liver all contribute to
fl
uid moving from
the vascular system into the peritoneal space.
9. Pathophysiolog
y
Cirrhosis with portal hypertension
Splanchnic vasodilation
Decrease in circulating arterial blood volume
Activation of renin-angiotensin and sympathetic nervous systems and antidiuretic
hormone
Kidney retains sodium and water
Hypervolemia
Persistent activation of systems for retention of sodium and water; ascites and edema
formation
Continued arterial under
fi
lling; cycle repeats
10. Clinical Manifestations
• Increased abdominal girt
h
• Rapid weight gai
n
• S h o r t o f b r e a t h a n d
uncomfortable from the
enlarged abdome
n
• Striae and distended veins may
be visible over the abdominal
wall (caput medusa).
• Umbilical hernia
• F l u i d a n d e l e c t r o l y t e
imbalances are common.
11. ESOPHAGEAL VARICES
Esophageal varices are dilated veins usually
found in the submucosa of the lower
esophagus, but they may develop higher in
the esophagus or extend into the stomach.
This condition nearly always is caused by
portal hypertension, which in turn is due to
obstruction of the portal venous circulation
within the damaged liver.
12. Risk factor
s
Risk factors that contribute to hemorrhage
are;
•Muscular exertion from lifting heavy
object
s
•Straining at stoo
l
•Sneezing, coughing, or vomitin
g
•Esophagitis; irritation of vessels by poorly
chewed foods or irritating
fl
uids; or re
fl
ux
of stomach contents.
13. Pathophysiology
Portal hypertension
Development of pressure gradient of 12 mm Hg or greater
Venous collaterals develop
from high portal system pressure to systemic vein
s
Formation of abnormal varicoid vessel
s
Vessels may rupture causing life-threatening hemorrhage.
16. Medical Management
DIETARY MODIFICATION
The goal of treatment for the patient with
ascites is a negative sodium balance to
reduce
fl
uid retention
.
DIURETICS
Use of diuretics along with sodium
restriction is successful in 90% of patients
with ascites.
PARACENTESIS
Paracentesis is the removal of
fl
uid (ascites)
from the peritoneal cavity through a small
surgical incision or puncture made through
the abdominal wall under sterile conditions.
17. Beta-blocker
s
Beta-blockers (nadolol or propranolol) may be
prescribed to reduce the pressure in varices and further
reduce the risk of bleeding
.
BALLOON TAMPONADE
To control hemorrhage in certain patients, balloon
tamponade may be used. In this procedure, pressure is
exerted on the cardia (upper ori
fi
ce of the stomach) and
against the bleeding varices by a balloon tamponade.
The tube has four openings, each with a speci
fi
c
purpose: gastric aspiration, esophageal aspiration,
in
fl
ation of the gastric balloon, and in
fl
ation of the
esophageal balloon.
18.
19. ENDOSCOPIC SCLEROTHERAPY
In endoscopic sclerotherapy (also referred to as injection
sclerotherapy), a sclerosing agent is injected through a
fi
beroptic
endoscope into the bleeding esophageal varices to promote thrombosis
and eventual sclerosis.
20. ESOPHAGEAL BANDING THERAPY (VARICEAL BAND LIGATION)
In variceal banding, a modi
fi
ed endoscope loaded with an elastic rubber
band is passed through an over-tube directly onto the varix (or varices) to be
banded. After suctioning the bleeding varix into the tip of the endoscope, the
rubber band is slipped over the tissue, causing necrosis, ulceration, and
eventual sloughing of the varix.
21. TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC
SHUNTING
Transjugular intrahepatic portosystemic shunting (TIPS) is a method of
treating esophageal varices in which a cannula is threaded into the
portal vein by the transjugular route. An expandable stent is inserted
and serves as an intrahepatic shunt between the portal circulation and
the hepatic vein, reducing portal hypertension.
22. SURGICAL MANAGEMENT
Several surgical procedures have
b e e n d e v e l o p e d t o t r e a t
esophageal varices and to
minimize rebleeding, but they are
often accompanied by signi
fi
cant
risk. Procedures that may be used
for esophageal varices are;
splenorenal and portacaval
venous shunts to relieve portal
pressure.