Portal Hypertension
Portal hypertension is a high pressure of blood in the portal system. The portal system is the system of veins that drain the blood from the small bowel to the liver. If there is obstruction to the drainage of blood - because of cirrhosis of the liver for example - then the pressure increases. This high pressure can be transmitted to veins in the stomach and oesophagus causing them to become tortuous and dilated, forming what are called varices. These can rupture and cause torrential haemorrhage. Surgery may be used to create a pathway, called a shunt, between the portal system and the venous system draining the rest of the body so that the pressure is reduced. Besides liver disease causing portal hypertension, it can be caused by problems producing blood clots in the hepatic veins, a condition called the Budd-Chiari syndrome. This occurs more often in patients who suffer from an increased likelihood to produce blood clots (a condition called thrombophilia - see blood and ciculation in the chest cavity section) and may be a complication of the oral contraceptive in susceptible patients. Girls with a family history of blood clots may wish to have their blood tested before taking the oral contraceptive.
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