Portal hypertension

Cirrhosis represents the end stage of any chronic liver disease. Two major syndromes result from cirrhosis: portal hypertension and hepatic insufficiency. Some of the complications of cirrhosis, such as varices and variceal hemorrhage, result almost solely from portal hypertension. Others, such as ascites and spontaneous bacterial peritonitis, result mostly from portal hypertension, but hepatic insufficiency contributes to their development. Another complication, portosystemic encephalopathy, is a consequence of both portal hypertension (shunting of blood through portosystemic collaterals) and hepatic insufficiency. Once the cirrhotic patient develops one of these complications and becomes ''decompensated,'' survival is significantly shortened. This paper reviews the recent advances in the pathophysiology and management of the complications of cirrhosis.