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PORTAL HYPERTENSION |
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pre-hepatic (no hepatomegaly): |
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portal vein thrombosis: |
umbilical sepsis in neonates (commonest cause in children)trauma pyelephlebitis secondary to abdominal surgery (rare) |
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extrinsic compression of portal vein: |
pancreatic disease lymphadenopathy at porta hepatis other tumours |
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congenital: |
atresia of portal vein |
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intra-hepatic: |
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liver cirrhosis (from any cause) alcoholic hepatitis (without cirrhosis) myeloproliferative disease congenital hepatic fibrosis nodular regenerative hyperplasia schistosomiasis (Schistosoma mansoni or S. japonicum) - pre-sinusoidal cause of portal hypertensiion |
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post-hepatic (tender hepatomegaly): |
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hepatic vein thrombosis [Budd-Chiari syndrome; hypercoagulability state]congenital webs in IVC or hepatic veins invasion of IVC by tumour, especially renal cell carcinomapolycystic disease of liver constrictive pericarditis or right ventricular failure posterior abdominal wall sarcomas hepatocellular carcinoma hepatic infection, e.g. hydatid cystradiotherapy trauma to liver toxic alkaloids in bush tea |
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due to increased portal blood flow (rare): |
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multiple arterio-venous fistulae increased splenic blood flow in splenomegaly |
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