Portal Hypertension - Cause

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What causes portal hypertension?

Portal hypertension occurs when there is an obstruction of blood flow through the liver and pressure rises within the portal vein. This obstruction can be intrahepatic (intra=within +hepatic=liver), pre-hepatic (pre=before) or post- hepatic (post=after).

Intrahepatic causes of portal hypertension

Intrahepatic causes of portal hypertension include cirrhosis and hepatic fibrosis or scarring. A wide variety of illnesses are implicated as the cause of portal hypertension. Examples include the following:

  • Alcohol abuse,
  • Hepatitis B and C infections,
  • Fatty liver (NASH, non-alcoholic steatohepatitis),
  • Wilson's disease, an abnormality of copper metabolism,
  • Hemochromatosis (iron overload), excess iron buildup
  • Cystic fibrosis
  • Primary sclerosing cholangitis, a hardening of the bile ducts
  • Biliary atresia, poorly formed bile ducts
  • Parasite infections such as schistosomiasis

Pre-hepatic causes of portal hypertension

  • Portal vein thrombosis or blood clots within the portal vein
  • Congenital portal vein atresia or failure of the portal vein to develop

Post-hepatic causes of portal hypertension

Post-hepatic causes are due to obstruction of blood flow from the liver to the heart and can include:

  • Hepatic vein thrombosis
  • Inferior Vena cava thrombosis
  • Restrictive pericarditis, where the lining of the heart stiffens and does not allow the heart to relax and expand when blood returns to it. Causes may include tuberculosis, fungal infections, tumors, connective tissue disorders (for example, scleroderma), and complications from radiation therapy.
Return to Portal Hypertension

See what others are saying

Comment from: Lila, 55-64 Female (Patient) Published: June 13

I was diagnosed with diabetes 15 years ago. About two years ago, I was diagnosed with portal hypertension and cirrhosis related to fatty liver. I do not drink alcohol. My blood sugar is under good control, with my most recent A1C rating at 6.6. I have lost weight, but I still need to lose about 20% of body weight to fall within the "normal" category.

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