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Blood Flow Through the Liver: How It Works
The liver receives blood from two sources.
If the pathway to the liver from the intestines is blocked or slowed because of obstruction or disease, then the pressure increases in the portal venous system. This is portal hypertension, and it leads to many consequences that have widespread effects throughout the body.
Causes of Portal Hypertension
Other causes of portal hypertension may or may not also cause cirrhosis and includeschistosomiasis,sarcoidosis, portal vein thrombosis, toxicity from vinyl chloride or medications, cancer occluding the intrahepatic portal vein, and miliary tuberculosis.
These disease processes may interfere with the passage of blood through the liver. The obstruction can occur within the portal vein, or blood flow through smaller veins in the liver can be blocked, causing a backup into the portal vein.
Portal hypertension causes several serious problems: ascites, varices, bleeding, and encephalopathy.
Acites
Ascitesis the accumulation of excess fluid in the tissues lining the organs and the abdominal wall. This occurs due to pressure and leaking of the lymphatic vessels.
Varices
When the blood flow in the liver is obstructed, the blood can become backed up into the intersections of the portal venous system (the system of veins transporting blood between the digestive system and liver) and the systemic venous system (the system of veins that returns blood to the heart).
The intersections of these two systems are small, fragile blood vessels called capillaries. These vessels are not able to withstand the increased blood pressure and become engorged or dilated.
These vessels are fragile and at risk for bleeding. This is a dangerous situation that can cause sudden and severe blood loss and accumulation of blood in the body cavities.
Causes of Gastrointestinal Bleeding in the Esophagus
Liver Failure
The liver plays a role in detoxifying chemicals in the body, as well as helping in the production of blood clotting factors. Severe portal hypertension can impair these functions.
Hepatic encephalopathyis a condition that causes behavioral problems and memory deficits as a result of liver failure.
And liver failure due to portal hypertension can cause bleeding susceptibility due to the deficiency of adequate clotting factors.
Diagnosis
Portal hypertension is diagnosed based on a combination of medical history, physical examination, and diagnostic tests. Anyone with advanced cirrhosis will be monitored closely for signs of portal hypertension.
Signs and symptoms can include any of the following:
If you have any of these signs or symptoms, your doctor may order an abdominal X-ray, ultrasound, or computerized tomography (CT) scan. You may also needliver function teststo assess your liver function.
Depending on your signs and symptoms, you may also have acomplete blood count (CBC), which can be used to determine whether you’ve had excess blood loss due to bleeding. Sometimes varices can be seen along the surface of the esophagus or stomach during anendoscopy procedure.
Treatment
The management of portal hypertension can involve emergency treatment, such as for acute variceal bleeding, or ongoing therapy, such as medication to reduce pressure in the portal vein and the varices.
Treatment often depends on the effects that you are experiencing. And interventions to reduce the risk of bleeding and progression of portal hypertension might be needed as well.
Some treatment options include:
Sometimes aliver transplantis considered as a possible treatment.
A Word From Verywell
SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bacon, BR. Cirrhosis and Its Complications. In: AS Fauci, E Braunwald, DL Kasper, SL Hauser, DL Longo, JL Jameson, J Loscaizo (eds),Harrison’s Principles of Internal Medicine, 17e. New York, McGraw-Hill, 2008. 1976-1978.Crawford, JM. Liver and Biliary Tract. In: V Kumar, AK Abbas, N Fausto (eds),Robbins and Cotran Pathologic Basis of Disease, 7e. Philadelphia, Elsevier Saunders, 2005. 883-885.Shah VH, Kamath PS. Portal Hypertension and Gastrointestinal Bleeding. In: M Feldman, LS Friedman, LJ Brandt (eds),Gastrointestinal and Liver Disease, 8e. Philadelphia, Elsevier, 2006. 1899-1928.
Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bacon, BR. Cirrhosis and Its Complications. In: AS Fauci, E Braunwald, DL Kasper, SL Hauser, DL Longo, JL Jameson, J Loscaizo (eds),Harrison’s Principles of Internal Medicine, 17e. New York, McGraw-Hill, 2008. 1976-1978.Crawford, JM. Liver and Biliary Tract. In: V Kumar, AK Abbas, N Fausto (eds),Robbins and Cotran Pathologic Basis of Disease, 7e. Philadelphia, Elsevier Saunders, 2005. 883-885.Shah VH, Kamath PS. Portal Hypertension and Gastrointestinal Bleeding. In: M Feldman, LS Friedman, LJ Brandt (eds),Gastrointestinal and Liver Disease, 8e. Philadelphia, Elsevier, 2006. 1899-1928.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bacon, BR. Cirrhosis and Its Complications. In: AS Fauci, E Braunwald, DL Kasper, SL Hauser, DL Longo, JL Jameson, J Loscaizo (eds),Harrison’s Principles of Internal Medicine, 17e. New York, McGraw-Hill, 2008. 1976-1978.Crawford, JM. Liver and Biliary Tract. In: V Kumar, AK Abbas, N Fausto (eds),Robbins and Cotran Pathologic Basis of Disease, 7e. Philadelphia, Elsevier Saunders, 2005. 883-885.Shah VH, Kamath PS. Portal Hypertension and Gastrointestinal Bleeding. In: M Feldman, LS Friedman, LJ Brandt (eds),Gastrointestinal and Liver Disease, 8e. Philadelphia, Elsevier, 2006. 1899-1928.
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