Portal hypertension is a type of liver disease characterized by increased blood pressure in the liver's portal vein — a major vein that transports blood from the stomach to the liver, large and small intestines, spleen, gallbladder, and pancreas. High blood pressure or hypertension in this vein is most often caused by cirrhosis of the liver (scarring of liver tissue). Other causes include blood clots in the vein and schistosomiasis — a parasitic infection common in Africa, sub-Saharan Africa, southern China, the Middle East, Southeast Asia, South America, and a few countries in the Caribbean.
Doctors in the Center for Advanced Digestive Care (CADC) at NewYork-Presbyterian/Weill Cornell Medical Center are leaders in the care of patients with all types of liver diseases, and have pioneered innovative treatments. The team includes all of the medical and surgical specialists required to care for patients with portal hypertension, offering comprehensive and personalized care customized to each patient's needs.
Symptoms of Portal Hypertension
Portal Hypertension Diagnosis
- During upper endoscopy, the doctor inserts an endoscope — a narrow, flexible tube equipped with a tiny light and camera — into the mouth, through the esophagus, and into the stomach. The patient receives a local anesthetic to ensure comfort during the procedure. The physician can see images of the digestive tract and may also take a tissue sample for analysis (biopsy).
- During ultrasound, sound waves are used to produce an image of blood vessels and internal organs and assess blood flow through the veins.
Treatment of Portal Hypertension
- With banding, a surgeon uses rubber bands to tie off blood vessels feeding the portal vein. This reduces blood flow and pressure in the portal vein and the likelihood that the vein will rupture or leak fluid.
- With sclerotherapy, physicians inject a liquid into the portal artery, which creates scar tissue. This treatment doesn't reduce pressure in the portal vein, but it does create a stronger protective "covering" to contain blood and fluid. Sclerotherapy is only done if banding cannot be performed.