Difference between revisions of "Portal Hypertension, Idiopathic Noncirrhotic"
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Latest revision as of 20:43, 28 June 2010
JAVMA paper
- Portal hypertension
- Sustained impairment of forward venous flow anywhere along the path from the portal vein to the right side of the heart.
- Luminal (thrombosis, parasites) or extraluminal obstruction (hepatic fibrosis or nodular regeneration) or relative restriction of flow due to massive portal volume overload (arterioportal fistulas).
- Hepatomegaly associated with posthepatic obstruction
- Microhepatica – associated with prehepatic/hepatic causes.
- Hepatic encephalopathy and GI bleeding not associated with posthepatic causes.
- Most common causes are RHS heart failure and severe diffuse hepatobiliary disease that results in cirrhosis.
Histology
- indistinguishable from microvascular dysplasia or surgically created portosystemic shunts
- Portal triad arteriole proliferation
- portal veins small to large
- variable portal triad fibrosis
- hepatic lobule size variation
- arterioles scattered throughout hepatic parenchyma
- portal veins – small
- expanded perivenular connective tissue by arterioles and distended lymphatics.