Reinus, John F.

Portal hypertension [electronic resource] / John F. Reinus. - London : Henry Stewart Talks, 2011. - 1 online resource (1 streaming video file (22 min.) : color, sound). - Gastroenterology and hepatology : pathophysiology, presentation, diagnosis and management, 2056-452X . - Henry Stewart talks. Biomedical & life sciences collection. Gastroenterology and hepatology. .

Animated audio-visual presentation with synchronized narration. Title from title frames.

Contents: Portal hypertension causes regional circulatory derangements that result in extra- and intra-vascular volume overload and organ dysfunction -- Vascular tone is mediated by autonomic input and chemical mediators many of which are released by local vascular endothelium -- Intrahepatic portal hypertension develops as a result of anatomic changes in the cirrhotic liver that cause sinusoidal narrowing and loss of compliance -- Reflex SMA vasoconstriction and portosystemic shunting up-regulate VEGF eNOS and iNOS with resultant vasodilation -- There is secondary: ADH secretion with retention of free water; renal salt retention; renal afferent arteriolar vasoconstriction -- Affected individuals develop progressive volume overload with associated afterload reduction and increases in cardiac output (hyperdynamic circulation) -- Fluid is forced off the surface of the liver and accumulates in the abdominal cavity as ascites -- Blood is shunted around the liver through latent venous connections that become varices -- Renal function is impaired (hepatorenal syndrome) -- Volume overload may cause secondary pulmonary hypertension -- Affected individuals may also develop primary pulmonary hypertension due to anatomic alterations of pulmonary microvasculature (porto-pulmonary hypertension) -- The ability of the heart to respond to stress is impaired -- Patients develop intrapulmonary shunts that cause hypoxemia (hepatopulmonary syndrome) -- The only real remedy for these problems is orthotopic liver transplantation.

Access restricted to subscribers.


Mode of access: World Wide Web.

2757 Henry Stewart Talks


Hypertension, Portal.
Technical University of Mombasa
Tom Mboya Street, Tudor 90420-80100 , Mombasa Kenya
Tel: (254)41-2492222/3 Fax: 2490571