Portal hypertension

Portal hypertension is defined as hepatic venous pressure gradient (HVPG) greater than 5 mmHg. HVPG is a surrogate for the portosystemic pressure gradient. Clinically significant portal hypertension is defined as a gradient greater than 10 mmHg and variceal bleeding may occur at a gradient greater than 12 mmHg. 

Causes can be split by their relation to the hepatic sinusoids:

  • dietary restriction
  • medication: propranolol, diuretics
  • interventional procedures
    • transjugular intrahepatic portosystemic shunt (TIPS)
    • surgical portosystemic shunt
    • surgical splenorenal shunt 
    • balloon dilatation of hepatic vein (in case of thrombosis/web in hepatic vein)
    • transhepatic clot thrombolysis (in portal vein thrombosis)
    • splenic artery embolisation 3
    • liver transplantation
  • treatment of complications

Dilatation of splenic veins at the splenic hilum without splenomegaly may occur in situations such as state of increased perfusion of splenic tissue associated with an immune response 6.

Hepatobiliary pathology
Ultrasound - general index
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Article information

rID: 1911
Synonyms or Alternate Spellings:
  • Raised portal venous pressures
  • Raised portal venous pressure
  • Raised portal vein pressures
  • Raised portal vein pressure
  • Elevated portal vein pressures
  • Elevated portal venous pressures
  • Elevated portal venous pressure
  • Elevated portal vein pressure
  • Increased portal vein pressure
  • PV hypertension
  • Portal venous hypertension
  • Portal vein hypertension
  • Increased portal venous pressure
  • Increased portal venous pressures

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Cases and figures

  • Case 1: recanalised paraumbilical vein
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  • DIOS
    Case 2: CF
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  • Case 3: varices
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  • Case 3: dilated portal vein
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  • Case 4: recanalised paraumbilical vein
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  • Case 5
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  • Case 6
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