How to Answer Shorten Diagnosis Portal Questions (Complete Guide)
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Original Question
Shorten ” Diagnosis of portal hypertension is often made at the time of variceal bleeding and confirmed by endoscopy and evaluation of portal venous pressure. Liver elastography (shear wave ultrasound or magnetic resonance imaging) provides a noninvasive measure of liver stiffness and extent of fibrosis.135 Distended collateral veins may radiate over the abdomen, giving rise to caput medusae (Medusa head) from opening of the paraumbilical veins. The individual usually has a history of hepatitis or alcoholism. Nonselective beta-blockers (that block both beta1 [β1 ] and beta2 [β2 ] receptors) can be effective in preventing variceal bleeding. Endoscopic vein ligation also is an option. Emergency management of bleeding varices includes fluid resuscitation, red blood cell replacement, prophylactic antibiotics, vasoactive drugs (e.g., octreotide, somatostatin, terlipressin), endoscopic variceal band ligation, compression of the varices with an inflatable tube or balloon, and injection of a sclerosing agent. Surgical construction of a transjugular intrahepatic portosystemic shunt (TIPS) (anastomosis of the portal vein to the inferior vena cava) may decompress the varices, but this treatment can precipitate encephalopathy or liver failure resulting from reduced hepatic blood flow.134 There is no definitive treatment for portal hypertension.
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