Cirrhosis and Portal Hypertension
Portal hypertension is increased pressure in the portal vein -- the main vein that receives blood from the stomach, small intestines, and spleen. The increased pressure is most often a symptom of liver disease and is most commonly caused by scarring in the liver (cirrhosis). It can occur when the veins leading into or out of the liver are blocked or as a result of chronic pancreatitis. In newborns, portal hypertension can result from umbilical infection. In cases of chronic pancreatitis and umbilical infection, the liver is usually normal.
Variceal Bleeding
Pressure on the portal vein causes blood flow to be restricted or pushed backward. This causes enlargement and lengthening of the veins in the stomach and esophagus. Enlarged veins are called varices. Excessive bleeding (hemorrhage) from the varices is a potentially life-threatening condition that must be treated because hemorrhage often recurs and is associated with a high risk of death.
Other Complications
Portal hypertension may cause the spleen to become enlarged. This may cause abdominal discomfort and, because the enlarged spleen holds blood cells, reduction of circulating platelets and white blood cells.
Other conditions that may develop as a result of portal hypertension include ascites and encephalopathy. Ascites is the buildup of fluid in the abdomen. This results from leakage of abdominal fluid out of the liver and the lining of the intestines. When the volume of leaking fluid exceeds the ability of the abdominal lining to absorb it, the fluid accumulates and causes abdominal stretching and expansion.
Encephalopathy is abnormal functioning of the brain. Encephalopathy caused by liver disease is characterized by mental changes that result from toxic substances reaching the brain without first being metabolized by the liver.