Management of Portal Hypertension

Abstract

An understanding of the basic pathophysiology, assessment, and pharmacologic, endoscopic, and surgical options in the management of portal hypertension is mandatory if intelligent and informed decisions are to be made concerning the treatment of patients who have portal hypertension and liver disease. Hemorrhage from gastroesophageal varices causes significant mortality. Complicating factors, including sepsis and portosystemic encephalopathy, markedly increase the morbidity of patients with end-stage liver disease. Adequate treatment of these problems can significantly prolong life and improve the quality of life in patients who have end-stage liver disease. Liver transplantation may be considered for acceptable candidates. However, given the current organ shortage, conservative modalities must be considered, as emergent liver transplantation is becoming less of an option. This review summarizes the basic pathophysiology, assessment, and treatment options in the management of patients with portal hypertension.