Pathophysiology of Portal Hypertension
作者:
Padraic MacMathuna,
Panglionas Vlavianos,
Dawd Westaby,
Roger Williams,
期刊:
Digestive Diseases
(Karger Available online 1992)
卷期:
Volume 10,
issue 1
页码: 3-15
ISSN:0257-2753
年代: 1992
DOI:10.1159/000171382
出版商: S. Karger AG
关键词: Portal hypertension;Pathophysiology;Cirrhosis;Varices;Alcohol;Hyperdynamic circulation
数据来源: Karger
摘要:
Portal hypertension is characterised by alterations in the splanchnic and systemic circulation associated with the development of portosystemic collateral channels, the most important of which are found in lower oesophagus and stomach. Bleeding from these gastro-oesophageal varices represents the major clinical complication and over the last decade there has been considerable interest in the pharmacological management of this condition. The factors underlying the development and maintenance of portal hypertension and the pathogenesis of variceal rupture are as yet not fully understood. Whilst an increase in portal vascular resistance, as a consequence of liver disease, appears to be the primary event in the majority of cases, increasing attention has focused on the potential importance of enhanced circulating levels of vasoactive compounds coupled with a proposed reduction in vascular sensitivity to endogenous vasoconstrictors. Consequently, portal hypertension is now being more widely considered as a multi-organ disorder associated with changes in blood flow within both systemic and splanchnic vascular beds. This article reviews the factors currently implicated in the development and maintenance of portal hypertension and considers the pathogenesis of variceal bleeding.
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