PORTAL HYPERTENSION 

• Normal portal vein pressure is 5 to 10 mm Hg (14 cm H2O).
• Portal hypertension may be defined as a portal pressure gradient of 13 mm Hg or greater and is often associated with varices and ascites.
• Many conditions are associated with portal hypertension, of which cirrhosis is the most common cause. 
  
  

Pathophysiologically: portal hypertension can be divided into presinusoidal and intrahepatic groups, depending on whether the hepatic vein wedged pressure is normal (presinusoidal) or elevated (intrahepatic). 

PORTAL HYPERTENSION

Consequences of portal hypertension are caused by blood being forced down alternate channels by the increased resistance to flow through the portal system. They include:

• Ascites (free fluid in the peritoneal cavity) 
• Hepatic encephalopathy 
• Increased risk of spontaneous bacterial peritonitis 
• Increased risk of hepatorenal syndrome 
• Splenomegaly (enlargement of the spleen) with consequent sequestration there in of red blood cells, white blood cells, and platelets, together leading to mild pancytopenia 
  portacaval anastomoses (Esophageal varices, hemorrhoids, caput medusae), with esophageal varices posing an ongoing risk of life-threatening hemorrhage.