"...portal hypertension refers to a higher than normal blood pressure in the portal system a normal range for this pressure is 5 to 10 millimeters of mercury portal hypertension can also be defined as a portal pressure more than 5 millimeters of mercury higher than the pressure in the inferior vena cava so the portal system refers to the portal vein which drains River and the main vessels that link to the portal vein and Superior mesenteric vein which comes from the small intestines the splenic vein which of course carries blood from the spleen the inferior mesenteric connects onto the splenic vein and carries blood from the large intestine but the gastric veins connect also on to the portal vein another thing to note is the umbilical vein which is normally obliterated and becomes the round ligament of the liver but if the pressure in the portal system gets high enough it can reopen varices are dilated veins that from an increased pressure in the portal system inside the liver you have structures known as sinusoids which are specialized capillaries within the liver the hepatocyte of the a separated from these sinusoids by a space known as the space of dese venous blood from the portal system mixes with arterial blood from the hepatic artery in the sign and then flows through into a central vein these Central veins collect together in the hepatic veins which takes blood into the inferior vena cava you can also see a which collects bile produced by the hepatocyte it's and takes it down towards the gallbladder the cell in red that you see inside the sinusoid is a cup for sale A specialized type of Mac the Scavenging and phagocytic activity the orange star shaped cells are important in Portal hypertension and cirrhosis these are hepatic stellate cells found in the space of these that are involved in fiberglass this and scaf formation in response to liver injury so what causes pressure in the portal system to increase the pathophysiology of portal hypertension ultimately comes down to blood being unable to pass smoothly from the portal circulation through the liver and into the inferior vena cava we typically divide the causes into pre hepatic intrahepatic post about it causes but remember that pre hepatic here means before the blood gets into the liver meaning causes in the portal vein itself well post hypnotic causes referred to causes after that two problems involving the inferior vena cava pre hepatic causes include portal vein thrombosis splenic vein thrombosis and arteriovenous malformation and splenomegaly intrahepatic causes include the most common cause cirrhosis which can come from alcohol abuse chronic viral hepatitis metabolic..."
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