Portal Hypertension

This book thoroughly covers various diseases induced by portal hypertension, and introduces novel information for the treatment of patients. Individual chapters address the pathophysiology, diagnosis and treatment options available for the complications induced by portal hypertension. The book fosters practical understanding and provides more evidence-based treatment options in order to improve physicians’ ability to select optimal treatment methods for their patients. Further, it offers readers the latest information concerning developments of the disease such as esophaogastric varices, ectopic varices, portal thrombosis, refractory ascites and hepatic encephalopathy. Clinical Science of Portal Hypertensions is an indispensible resource for both beginning and experienced gastroenterological physicians, endoscopists, liver physicians, radiologists, gastroenterological surgeons, liver surgeons, etc. who treat patients with portal hypertension on a clinical or research basis.

This book will be an excellent tool for practitioners seeking an update on the latest developments in the diagnosis and management of cirrhosis and portal hypertension. Among the topics addressed are risk stratification, prognosis, screening and surveillance, impact of etiological and antifibrotic therapy, the gut microbiome and cirrhosis, prevention of decompensation/further decompensation, management of the acute bleeding episode, controversies in pediatrics, and vascular diseases of the liver in cirrhotic and noncirrhotic portal hypertension. The book is a compilation of lectures and important consensus statements from the Sixth Baveno International Consensus Workshop on Portal Hypertension, the most recent of a series of workshops held every 5 years for hepatologists with an interest in the field. Portal Hypertension VI will serve as a reference book for clinical and research fellows in Gastroenterology and Hepatology and should inspire new research projects in the areas identified as promising by the experts of the Baveno VI Faculty.

Portal hypertension is a relatively common condition, the complications of which are frequently life threatening. Patients with portal hypertension represent an important por tion of the daily clinical work of abdominal radiologists, gastroenterologists and abdominal surgeons. During the past two decades the development of new radiological devices and of new percutaneous image-guided treatment methods has resulted in fundamental changes in the clinical management of patients with portal hypertension. During the same period tremen dous progress was achieved in the visualization of the numerous morphological and func tional changes observed in patients with portal hypertension, due to the clinical introduc tion of the new cross-sectional imaging methods: ultrasonography, computed tomography and magnetic resonance imaging. I am very grateful to Prof. Plinio Rossi, an internationally recognized leader in the field of interventional radiology, for accepting the challenging task of compiling and presenting in a structured way the numerous facts and data that have become available during the past few years in this rapidly developing field. The editor has been inspired and successful in his selection of the impressive group of international experts that has contributed to many chapters of this volume.

This book, the seventh in a series of proceedings volumes that began in 1995, reviews the latest developments in the diagnosis and management of cirrhosis and portal hypertension. It addresses a broad range of topics, including: risk stratification, HVPG, non-invasive surrogates for cACLD, CSPH, varices, progression and regression of cirrhosis, impact of etiological therapy on cirrhosis, impact of non-etiological novel therapies on cirrhosis, prevention of first/further decompensation, acute variceal hemorrhage, and Vascular Liver Disorders in Cirrhosis (VALDIG). The book is a compilation of lectures and important consensus statements from the Seventh Baveno International Consensus Workshop on Portal Hypertension, the latest in a series of workshops held every five years for hepatologists with an interest in the field. Portal Hypertension VII offers a valuable reference guide for clinical and research fellows in Gastroenterology and Hepatology and will inspire new research projects in the promising areas identified by the experts of the Baveno VII Faculty.

A cutting-edge review of the latest findings on key scientific topics and the best strategies for evaluation and management of portal hypertension in the clinic. Writing in an easy-to-read style, the authors review its pathobiology, the progress being made in its experimental understanding, the methodologies to assess it in humans, the treatment of its complications (esophageal varices, ascites, and hepatorenal syndrome), and its treatment in special circumstances (during pregnancy, in children, or when the portal vein is blocked). They also provide in-depth coverage of the pros and cons of the various therapeutic choices available to the clinician managing patients with complicated portal hypertension.

This book provides a comprehensive account on individually rare, but collectively frequent diseases of the liver. In the first part, conditions such as hepatic vascular malformations, ischemic cholangiopathy, hepatic artery occlusion, sinusoidal conditions and Budd-Chiari syndrome are discussed among others. The second part examines the causes of vascular liver disease namely, coagulation disorders, neoplasm disorders, non-malignant blood disorders, systemic diseases and toxins, among others. The unique expertise of the authors, who are all members of the Vascular Liver Disease Disorders Group, an independent network of researchers with a common interest in Vascular Liver Diseases, are merged for an optimal pragmatic and individualized approach. This book is of interest to a broad range of experts, such as hepatologists, internists, radiologists and angiologists.

Portal hypertension is the abnormal pathophysiologic state that develops in liver cirrhosis and certain other disorders with characteristic clinical and hemodynamic features. There has been great progress in our under standing and management of portal hypertension, particularly in the diagnostic and therapeutic approaches. The so-called Banti's syndrome, a disorder whose existence had long been questioned, is now a well-defined portal hypertensive disease. The recently introduced Doppler ftowmetry is currently yielding new information on portal hemodynamics. Endoscopic sclerotherapy and beta-blockers have come to be widely used in the man agement and prevention of variceal bleeding. In spite of all these advances, a number of unsolved questions remain, such as whether sclerotherapy, pharmacotherapy or surgery is warranted for prevention of bleeding, which is more effective as an elective treatment, the surgical or endoscopic approach, and whether surgical portacaval shunt should be totally replaced by selective shunt operations. These new developments and problems are clearly and comprehensively described and discussed by the foremost authorities in 44 chapters, which are divided into five sections: 1) Patho physiology, 2) Hemodynamic Investigations, 3) Imaging Investigations, 4) Clinical and Pathological Features, and 5) Esophageal and Gastrointestinal Bleeding. The primary goal of this monograph, to provide a framework of patho physiology of portal hypertension with authoritative descriptions of the clinical and laboratory manifestations of various portal hypertensive dis orders, has clearly been achieved by these excellent contributions.