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Chapter: Medical Surgical Nursing: Assessment and Management of Patients With Hepatic Disorders

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Portal Hypertension - Hepatic Dysfunction

Obstructed blood flow through the damaged liver results in in-creased blood pressure (portal hypertension) throughout the portal venous system.

PORTAL HYPERTENSION

 

Obstructed blood flow through the damaged liver results in in-creased blood pressure (portal hypertension) throughout the portal venous system. Although portal hypertension is commonly associated with hepatic cirrhosis, it can also occur with noncir-rhotic liver disease. While splenomegaly (enlarged spleen) with possible hypersplenism is a common manifestation of portal hy-pertension, two major consequences of portal hypertension are ascites and varices.

 

In ascites, fluid accumulates in the abdominal cavity. Al-though ascites is often a result of liver damage, it may also occur with disorders such as cancer, kidney disease, and heart failure. Varices are varicosities that develop from elevated pressures trans-mitted to all of the veins that drain into the portal system. They are prone to rupture and often are the source of massive hemor-rhages from the upper GI tract and the rectum. In addition, blood clotting abnormalities, often seen in patients with severe liver disease, increase the likelihood of bleeding.

 

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