What is gastric vein

Portal hypertension (portal hypertension)

Which therapy the doctor chooses is decided on an individual basis. First and foremost, the respective underlying disease (e.g. hepatitis C, alcohol-related liver cirrhosis or portal vein thrombosis) is treated.

All pathogenic changes such as nutrient deficiency, bleeding tendency and risk factors with regard to liver performance, but also the cardiovascular system, must be taken into account.
The prevention of secondary diseases is also very important in the care of patients with portal hypertension.

Endoscopic or drug treatment for gastric or esophageal varices can reduce the risk of (renewed) variceal bleeding. The doctor can prescribe a beta blocker for this. The constriction of varices (ligature) as part of an endoscopy is also possible.

If the response is inadequate, certain stent connections between the portal and venous blood circulation from the liver to the heart may be considered.

In the intrahepatic portosystemic (stent) shunt (TIPS / TIPSS), a plastic tube is inserted through the large jugular vein under ultrasound control. This is carried to the liver and through the liver tissue to the portal vein (Vena portae). A (sometimes several) metal tube (stent) is inserted over the plastic tube and fixed in the liver. This keeps the connection between the portal vein and a hepatic vein open. The blood flows from the liver tissue via hepatic veins into the inferior vena cava (inferior vena cava). The connection between the portal vein and the hepatic vein allows congested blood to drain away, bypassing the liver tissue.

The creation of a peritoneovenous shunt (PVS) is also an option. This creates a connection between the abdomen and the superior vena cava (superior vena cava). This allows fluid from the abdomen to be returned to the blood system.

However, these two shunts increase the risk of developing hepatic encephalopathy. The long-term prognosis is only slightly improved by all these measures.

A liver transplant can be done if you have severe liver disease. Portal hypertension usually regresses after a transplant.