DIAGNOSIS OF PORTAL HYPERTENSION. Literature & Language Coursework (Coursework Sample)

DIAGNOSIS OF PORTAL HYPERTENSION
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Portal hypertension
Introduction
Portal hypertension is characterised by an abnormal increase of the blood pressure in a network of veins referred as the portal venous system. Veins emerging in the stomach, spleen, pancreas as well as intestine diverge in the portal vein, which then branches into reduced vessels and passes through the liver (WebMD 2018). When these vessels are blocked due to some damaged of the liver, the blood will cease to flow normally through the liver (Sauerbruch, Schierwagen and Trebicka 2018). Consequently, this will cause a change in the flow gradient that leads to an elevation of the blood pressure in the portal system. Sauerbruch, Schierwagen and Trebicka (2018), further explain that the increased obstruction of the venous flow will result to a development of large varices (swollen veins) in various parts of the middle section of the human anatomy including the oesophagus, umbilical area, rectum or the stomach.
Specifically, portal hypertension is expressed when portal blood pressure is set above the normal values of between 1 and 5 mm HG. Samonakis et al. (2004) explain that for the condition to be considered clinically significant the pressure surpasses the 12mm HG threshold since at this point the rate of mortality and morbidity are quite high. The mechanism that leads to portal hypertension can explain by a duo hemodynamic process (Al-Busafi et al., 2012). The first part of the process is the amplified intrahepatic impediment of the blood flow passage across the liver as a result of cirrhosis. Secondly, the augmented splanchnic flow of blood tributary to the vasodilatation occurrence in the splanchnic vascular area. Portal hypertension occurs from possibly various causes in the prehepatic, intrahepatic, and posthepatic regions (Samonakis et al. 2004). In the western countries, the liver cirrhosis has been identified as the major cause contributing to about ninety percent of the cases. The purpose of compiling this paper is to explore the causes, diagnosis, and manifestation, the prognosis as well as the treatment of portal hypertension.
Background
A 38 years old Briton male was admitted with complaints of occasional bloodstains in the bowel. In addition, he reported to experience increased abdominal pains over the last couple of months and have lost approximately 8 kilograms over the eight weeks despite having a proper diet. There is no significant medical history but the information during a recent visit to a private clinic, the medical practitioner noted some of the levels of confusion. This signs indicated possible infection of the liver, which could have developed into portal hypertension.
Portal Hypertension
Aetiology
The primary cause of PH is the presence of liver cirrhosis, a scar that is left healing from an injury caused by alcohol, hepatitis or other causes of liver damages. It causes inflammation of the cytokines intrinsic in the immune system (Iwakiri and Groszmann 2014). The factors that may contribute to elevated intrahepatic blood flow impediment for a patient suffering from liver cirrhosis include dysfunctional endothelial cells, stimulation of hepatic stellate cells (HSCs), and a notable level of liver angiogenesis (Bosch 2007). In cirrhotic patients, the liver fails to make an adequate synthesis of the NO and therefore, this will worsen the case of portal hypertension. The intrahepatic vascular resistance can occur when the HSCs are activated. An injury on the liver triggers the activation of the HSCs and then transformation process takes places whether they become myofibroblas