liver and gallbladder disorders
Portal Hypertension
Treatment of Portal Hypertension
For bleeding, drugs to slow bleeding, blood transfusions, and/or endoscopy Sometimes surgery to reroute blood flow (portosystemic shunting) Sometimes liver transplantation Stopping the bleeding is a medical emergency. Drugs such as To reduce the risk of bleeding from esophageal varices, doctors may try to reduce pressure in the portal vein. One way is to give beta-blocker drugs, such astimolol,propranolol,nadolol, orcarvedilol. Doctors regularly monitor people who have had bleeding from varices because bleeding may recur. If the bleeding continues or recurs repeatedly, a procedure called portosystemic shunting may be done to connect the portal vein or one of its branches to a vein in the general circulation. This procedure reroutes most of the blood that normally goes to the liver so that it bypasses the liver. This bypass (called a shunt) lowers pressure in the portal vein because pressure is much lower in the general circulation. There are various types of portosystemic shunt procedures. In one type, called transjugular intrahepatic portosystemic shunting (TIPS), doctors, using x-rays for guidance, insert a catheter with a needle into a vein in the neck and thread it to veins in the liver. The catheter is used to create a passage (shunt) that connects the portal vein (or one of its branches) directly with one of the hepatic veins. Less commonly, portosystemic shunts are created surgically. Shunt procedures are usually successful in stopping the bleeding but pose certain risks, particularly Hepatic Encephalopathy . The procedure may have to be repeated because the shunt may become blocked. Some people require Liver Transplantation . 