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Case #5 -
A 45 year old with progressive abdominal distension

DISCUSSION QUESTIONS:
2.) What are the etiologies of portal hypertension and the associated disease states?

Etiologies of portal hypertension and associated disease states:




  • Extrahepatic outflow obstruction - Budd-Chiari syndrome

  • Obstruction of extrahepatic portal venous system: trauma, infection, external compression, cavernous transformation of portal vein.

  • Intrahepatic obstruction:


    • Presinusoidal: Schistosomiasis, sarcoidosis, congenital hepatic fibrosis

    • Sinusoidal: post-necrotic cirrhosis, alcoholic hepatitis, nodular regenerative hyperplasia

    • Postsinusoidal: alcoholic cirrhosis


  • Increased flow states: massive splenomegaly, splenic arteriovenous fistula

 
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