Portal Hypertension in Cirrhosis

Bosch, Jaime; Berzigotti, Annalisa

doi:10.1002/9781119237662.ch11

Cited by 7 publications

(7 citation statements)

References 86 publications

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“…The transition from compensated to decompensated liver cirrhosis is affected by many predisposing factors, where 33% have transitioned within 4 years. [15][16][17][18] Based on gender, male patients were higher than females, with 49 patients at 76.6%, and had the highest frequency of ascites, with 38 at 59.4%. This result is in line with the study conducted by Nababan et al, who analyzed 241 victims of decompensated cirrhosis, with a male predominance of 74.3%.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Absolute Lymphocyte Count and Ascites in Patients with Liver Cirrhosis

Riyadi,

Carmelita,

Sasmithae

et al. 2024

InaJGHE

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Background: Cirrhosis is the final stage of liver disease characterized by fibrosis and irreversible nodule formation due to chronic inflammation. The most common liver cirrhosis complication is ascites, where pathological fluid accumulates in the peritoneal cavity. In cirrhosis, lymphocytes infiltrate the liver and contribute to stellate cell activation, differentiation, and the fibrogenic response. Many recent studies have not studied a relationship between the absolute lymphocyte count and ascites in liver cirrhosis. Therefore, it is important to investigate the relationship between lymphocytes and ascites in liver cirrhosis.Method: This is an observational study with a cross-sectional design study. Held in August–October 2022 at Dr. Doris Sylvanus Hospital's Medical Record Installation. 64 samples were selected based on inclusion and exclusion criteria. Meanwhile, absolute lymphocyte count were measured from the patient's blood tests or by calculation. Ascites were diagnosed by physical examination and radiology. The relationship between absolute lymphocyte count and ascites was analyzed using the chi-square test, with the results considered statistically significant when the p-value 0.05.Result: The medical records from April 2019 to April 2022, there were 64 samples, of which 15 and 49 were without and with ascites. Based on the chi-square test results, there was a significant relationship between absolute lymphocyte count and the incidence of ascites, with p = 0.02.Conclusion: This study concluded that there is a relationship between absolute lymphocyte count and ascites in patients with liver cirrhosis, where absolute lymphocyte count tends to decrease.

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Section: Discussionmentioning

confidence: 99%

Relationship between Absolute Lymphocyte Count and Ascites in Patients with Liver Cirrhosis

Riyadi,

Carmelita,

Sasmithae

et al. 2024

InaJGHE

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“…The elevated portal pressure that associated to diseases other than cirrhosis, is defined as non-cirrhotic portal hypertension (NCPH). 1,2 The prevalence of NCPH is difficult to be estimated due to the many underlying etiologies, various terminologies to describe the similar entity, and lack of epidemiology reports. Portal hypertension that is not associated with cirrhosis and extrahepatic obstruction of portal vein, is first time described as non-cirrhotic portal fibrosis (NCPF).…”

Section: Definition and Prevalancementioning

confidence: 99%

Non-Cirrhotic Portal Hypertension: An Update of Diagnosis and Management

Zulkifly,

Hasan

2023

InaJGHE

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Portal hypertension is not the only caused by liver cirrhosis. Non-cirrhotic portal hypertension (NCPH) is characterized by elevated portal pressure in the absence of cirrhosis and is often underdiagnosed in daily clinical practice. The clinical manifestations of NCPH are similar to liver cirrhosis. The diagnosis of NCPH is still challenging due to the various underlying etiologies and often require either non-invasive or invasive examination. Laboratory examination, abdominal ultrasound, endoscopic procedure, hepatic venous gradient measurement, and liver biopsy have role in diagnosis of NCPH. The principle management of NCPH is to treat portal hypertension and its complications, such as prophylaxis and acute management of variceal bleeding, anticoagulants, surgery, splenectomy, and liver transplantation.

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“…Sinusoidal PH, the most common form of PH, occurs in diseases that affect the liver parenchyma, cirrhosis being the main cause. In postsinusoidal PH, the pathological substrate is located distal to the sinusoids and is caused by obstruction of central veins (e.g., sinusoidal obstructive syndrome) [ 2 ]. Cirrhosis and schistosomiasis are responsible for more than 90% of cases of PH worldwide [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…In such cases, PH is classified as prehepatic. When the obstruction happens after the blood exits the liver, for example in Budd-Chiari syndrome, PH is classified as posthepatic [ 2 ]. The gold standard for assessing the severity of PH is measurement of the hepatic venous pressure gradient (HVPG).…”

Section: Introductionmentioning

confidence: 99%

“…The normal value of HVPG ranges from 1 to 5 mmHg, values between 6 to 9 mmHg are considered subclinical PH, and values ≥ 10 mmHg are considered clinically significant portal hypertension (CSPH). Measurement of HVPG reliably reflects the severity of PH in patients with sinusoidal causes, while its values are normal or only slightly elevated in pre- and postsinusoidal forms of PH, where it lacks prognostic value but still holds diagnostic significance [ 1 , 2 , 4 ]. The classification and clinical features of different forms of PH are summarized in Table 1 .…”

Section: Introductionmentioning

confidence: 99%

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Porto-sinusoidal vascular disease: a new definition of an old clinical entity

Barisic-Jaman,

Milosevic,

Pastrovic

et al. 2023

ceh

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Porto-sinusoidal vascular disease (PSVD) is defined as a vascular liver disease characterized by the absence of cirrhosis and the presence of characteristic histological features, with or without the presence of portal hypertension (PH). Half of the patients with PSVD also have associated disease that may contribute to the development of PSVD. Patients usually remain asymptomatic until complications of PH arise. Variceal bleeding and portal vein thrombosis are major complications associated with PSVD. The treatment is focused on managing complications of PH, mainly through primary prophylaxis of variceal bleeding and treatment of portal vein thrombosis. Currently, there is insufficient evidence to support the use of anticoagulants for thrombosis prevention in these patients. Despite the increase of recognition of PSVD, further research is needed to enable early disease diagnosis, establish optimal screening methods, and develop strategies to slow down disease progression.

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Portal Hypertension in Cirrhosis

Cited by 7 publications

References 86 publications

Relationship between Absolute Lymphocyte Count and Ascites in Patients with Liver Cirrhosis

Relationship between Absolute Lymphocyte Count and Ascites in Patients with Liver Cirrhosis

Non-Cirrhotic Portal Hypertension: An Update of Diagnosis and Management

Porto-sinusoidal vascular disease: a new definition of an old clinical entity

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