Portal hypertension is a type of liver disease characterized by elevated blood pressure in the 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. 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 at 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. Care for portal hypertension is often led by physicians at the Center for Liver Disease and Transplantation, the world-renowned liver center based at NYP
Symptoms of Portal Hypertension
- Blood in vomit or stools
- Confusion or forgetfulness
- Low white blood cell counts
- Swelling of legs and feet
Diagnosis of Portal Hypertension
- Upper GI endoscopy
- Various other imaging techniques including x-rays, CT scans, or an MRI.
- Blood tests
Treatment of Portal Hypertension
Doctors at the CADC and the Center for Liver Disease and Transplantation can use several different types of procedures to treat portal hypertension. c
- With banding, a gastroenterologist uses rubber bands to tie off varices. This reduces blood flow and pressure and the likelihood that the varices will rupture.
- With sclerotherapy, physicians inject a liquid into the varices, which creates scar tissue. This treatment does not reduce pressure in the varices, but it does create a stronger protective "covering" to contain blood. Sclerotherapy is only done if banding cannot be performed.
- CADC doctors sometimes treat severe portal hypertension with a procedure known as "transjugular intrahepatic portosystemic shunt," or TIPS. Before undergoing TIPS, patients have a number of tests to assess the function of their liver, heart, and kidney and to help determine the extent and severity of the portal hypertension. These tests may include echocardiography (the use of ultrasound to evaluate heart function), endoscopy, blood tests, and angiography. TIPS is typically used in patients where neither banding nor sclerotherapy can stop bleeding from varices or and when diuretic medication cannot control ascites fluid.