Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Up to now, laparoscopy has always been considered as only marginally importan in the study of portal hypertension whereas in fact it should become one of the fundamental examinations in this field. The technique not only contributes, by direct liver exploration, to a more precise judgment regarding the underlying disease, with the possibility of earlier recognition of pre-hepatic, intra-hepatic and post-hepatic forms of portal hypertension, but also makes it possible to detect the earliest signs of hypertension. Further, and most important, laparoscopy extends investigation of the collateral circulation to the sector of the small peritoneal vessels which are inaccessible with other techniques, demonstrating alterations are of decisive importance in the economy of the collateral circulation. On the basis of these new elements, together of course with radiological and fibro-endoscopic data, it is possible to divide cases of portal hypertension into three groups depending on the type of collateral circulation operative on each occasion. These types present differing anatomcfunctional features and clinical physiognomy, a factor of great practical importance especially for the purpose of establishing indications for the portacaval anastomosis of choice, and possibly prophylactic intervention.
 ...
PMID:[The value of laparoscopy in the study of portal hypertension]. 12 45

We report a case of idiopathic portal hypertension which is related to chronic arsenic poisoning. Only 7 cases have been reported previously. The patient presented with bleeding esophageal varices. Splenomegaly and hyperkeratosis of palms and soles were later noted and led to the discovery of chronic arsenic poisoning. The hemodynamic studies revealed a gradient between the splenic pulp pressure and hepatic wedge pressure which is consistent with presinusoidal hypertension. The liver histology revealed only mild portal fibrosis. Arsenic poisoning is one cause of idiopathic protal hypertension.
 ...
PMID:Idiopathic portal hypertension and chronic arsenic poisoning. Report of a case. 15 97

From the surgical point of view is reported on the therapy of the portal hypertension by operations of anastomoses decreasing the pressure. Here the treatment of the haemorrhage of the oesophageal varices dangerous to life is in the first place. The porto-caval shunt is justified and successful in this emergency situation, since it has the decisive advantages of a short time of operation and an optimal release of pressure. Obstructive operations are indicated only in exceptional cases. Issuing from the haemodynamic criteria and from the moment of haemorrhage, the indication to the typical shunt operations is explained. Hereby it is established that the surgery of portal vessels is still considerably burdened by the postoperative encephalopathy. The modern anastomotic operations are directed to its prevention. Finally the author adopts a definite attitude to the peculiarities of the hypertension of the portal vein in children and it is in short referred to the operative treatment of the therapy-resistent ascites as well as of the hypersplenism.
 ...
PMID:[Surgical treatment of portal hypertension]. 30 Sep 52

Following a mesocaval interposition shunt in three patients with cirrhosis of the liver, bleeding esophageal varices recurred in two and left sided portal hypertension partially persisted in one patient. Angiographic and pressure studies of the portal system demonstrated effective decompression of the greater splanchnic venous system but continued lesser splanchnic venous hypertension. Recurrent variceal hemorrhage ceased following splenectomy done as an emergency. In contrast to a standard portacaval shunt, it is suggested that after an interposition mesocaval shunt, altered jet streaming of mesenteric blood flow may divert gastrosplenic venous drainage away from the interposition shunt with persistence of lesser splanchnic venous hypertension. Recognition of this entity and of the need for splenectomy is advocated.
 ...
PMID:Left sided segmental portal hypertension following mesocaval interposition shunt. 30 66

The authors reports the results of 171 cases of portal systemic by pass operations out of a total of 200 cases operated on between 1968 and 1974. These 171 patients all presented with a syndrome of portal hypertension with oesophageal varices and all had previously bled. Their age lay in 70 p. cent of cases between 40 and 60 years and the cause of hypertension was in 96 p. cent of cases an intra-hepatic block. 41 p. cent were included in the risk group A according to Child's classification, 51 p. cent in Group B and 8 p. cent in Group C. The routine operation was side-to-side portacaval anastomosis (75 p. cent). The operative mortality was 5.2 p. cent in all with 1 p. cent in cases with risk A, and 15 p. cent in cases with risk C. The fall in portal pressure was on average 15 cm of water, i.e. 41 p. cent of the initial pressure. The overall survival after 5 years was 65 p. cent, 70 p. cent for risk A and 26 p. cent for risk C. In 69 p. cent of cases the cause of death was liver failure. Encephalopathy, studied in 76 patients over an average period of 3 years, occurred in 39 p. cent of cases, and in 13 p. cent of the latter it was serious. In the 12 p. cent of survivors, we noted recurrent hemorrhage, but in only 2.5 p cent of cases did the bleeding definitely come from oesophageal varices. In the light of these results, the authors judge positively the surgical treatment of portal hypertension.
 ...
PMID:[Immediate and late results of 171 therapeutic portal systemic by pass operations (author's transl)]. 30 46

The generally held views that plasma renin activity (PRA) is increased in cirrhosis and that this is secondary to reductions in the "effective" blood or extracellular fluid (ECF) volumes, consequent on the effects of portal hypertension, were re-examined in the present study. Measurements of PRA in 67 patients representing different clinical stages of cirrhosis showed that the mean value in 15 patients without ascites was significantly reduced. In 21 of 35 with ascites, PRA was either reduced or within the normal range. A low plasma renin substrate concentration was not the cause for the low PRA. These findings are not in keeping with the concepts of reduced "effective" blood or ECF volumes at least for the majority of patients at these stages of cirrhosis under the conditions of the present study. The only group showing a significantly increased PRA had evidence of renal impairment. In these 17 patients the underlying reduction in renal perfusion may have been the stimulus to the kidney that led to an increase to renin secretion.
Hypertension
PMID:Changes in plasma renin activity in cirrhosis: a reappraisal based on studies in 67 patients and "low-renin" cirrhosis. 39 38

This is a report of a patient with a thrombosed Warren shunt and recurrent variceal hemorrhage who demonstrated compartmentalized venous hypertension in the mesenteric and gastrosplenic systems. Although the mesenteric presssure was normalized by the construction of a mesocaval interposition shunt, the gastrosplenic venous pressure remained elevated until splenectomy was performed. Warren shunt occlusion should be considered as a cause of segmental portal hypertension. Splenectomy may be a necessary adjunct in patients suitable for reshunting.
 ...
PMID:Compartmentalized gastrosplenic and mesenteric venous hypertension after distal splenorenal shunt occlusion: response to mesocaval shunt and splenectomy. 43 20

Regencrative nodular hyperplasia (RHN) is a rare condition, the diagnosis of which is based upon histological findings. It is seen in Felty's syndrome with portal hypertension (PHT), as was the case in the patient reported here. This was a 72-year-old man, with long standing rheumatoid arthritis, hepatosplenomegaly, a neutrophil leucopaenia and oesophageal varices responsible for recurrent haematemeses. Despite a portocaval anastomosis, the patient died from postoperative acute hepatic failure. Histological study revealed changes in the hepatocytes and the reticulin system typical of RNH without cirrhosis. The relationship between Felty's syndrome and RHN, as well as the mechanism of the hypertension, are discussed in the light of cases from the literature.
 ...
PMID:[Anatomo-clinical study of a case of regenerative nodular hyperplasia of the liver with Felty's syndrome and portal hypertension]. 54 55

Hyperkinetic portal hypertension is caused by pathological arterioportal shunts. Clinical differentiation is necessary between extrahepatic fistulas, splenoportal hypertension (arteriovenous anastomoses at the level of the pre-penicilary arteries) and intrahepatic fistulas in "active" cirrhosis and malignant tumors. This paper reports the clinical and angiographic features of eight patients with this type of fistula. A review of the literature is also presented (144 cases). Because of the severity of this disease, surgical intervention is necessary. The surgical technique depends on the organ-related necessity of vascular preservation.
 ...
PMID:[Hyperkinetic portal hypertension. Arterioportal fistula: problems--case reports--review of the literature]. 64 68

A study was done on the action of splenohepatoplasty upon intrahepatic and prehepatic portal hypertension. Portal hypertension was induced Wistar rats following the establishment of cirrhotic conditions. Hepatic cirrhosis was obtained in these rats by an oral, daily dose of tioacetamide during a four and five month period. Prehepatic hypertension was produced in dogs by the installation of a rubber cylinder, completely covered by cellophane paper, around the trunk of the vena porta. This procedure brought about a progressive compression of the vena porta. The application of splenoheptoplasty is a highly valuable treatment for portal hypertension as a derivative system and for intrahepatic portal hypertension as a derivative regenerative system.
 ...
PMID:Simultaneous treatment of portal hypertension and hepatic cirrhosis by splenohepatoplasty. 68 92


1 2 3 4 5 6 7 8 9 10 Next >>