How to Diagnose Portal Hypertension

Portal hypertension is an elevation in the pressure of the hepatic portal circulation, usually defined as 12 mm of mercury. Blood pressure is affected by changes in blood flow and resistance to flow, with both of these increased in most types of portal hypertension. Liver disease is the most common cause of portal hypertension and variceal hemorrhaging is the most common complication. Here's how to diagnose portal hypertension.

Instructions

• 1

  Obtain the patient history to determine the cause of the portal hypertension. A history of alcohol abuse, blood transfusion, intravenous drug use, itching and jaundice may exist. A family history may reveal liver diseases, such as hemochromatosis or Wilson's disease.

• 2

  Look for symptoms of complications from portal hypertension. These include bleeding from gastroesophageal veins, changes in mental status, increases in abdominal girth, abdominal pain and fever.

• 3

  Detect signs of blood accumulation in the portal system. The anterior abdominal wall may show dilated veins. There may be a venous pattern in the flanks and convoluted collateral veins near the umbilicus.

• 4

  Direct laboratory studies toward investigating cirrhosis, which is usually the cause of portal hypertension. These should include liver function tests, blood coagulation time, serologies for viral hepatitis and platelet counts.

• 5

  Perform ultrasound as an effective screening method for portal hypertension. It can show blood flow through the portal system and assist in diagnosing blood clots in the portal and splenic veins. Findings suggestive of cirrhosis with portal hypertension include a nodular surface of the liver and a swollen spleen.