Increased door vein pressure in cirrhosis is a common symptom. Increased door vein pressure in cirrhosis causes digestive hemorrhage, which is the leading cause of death of cirrhosis if not treated in a timely manner.
1. Overview of increased door vein pressure in cirrhosis
Increased door vein pressure in cirrhosis is a common symptom. Door veins are veins that transport blood from such muscles as the stomach, small intestine, large intestine, spleen, pancreas to the liver. Cirrhosis is a condition in which liver tissues are damaged, causing a deterioration of chronic liver function, thereby affecting the veins that transport blood to the liver – the door vein, leading to an increase in door vein pressure.
In children, increased pressure of the veins outside the liver is a congenital disease or acquired by many causes such as peritonitis, enteritis, infection, catheter settingment at birth, … Increased pressure of the veins outside the liver in young children if not treated can lead to cirrhosis of the liver.
2. Symptoms of increased door vein pressure in cirrhosis of the liver
Cirrhosis causes increased pressure of the door vein with the following symptoms:
- Vomiting blood: Due to increased pressure of the door vein dilates and ruptures the veins of the urethor, causing digestive hemorrhage. This is a typical symptom and the leading cause of death if not treated in a timely manner.
- Cerebral hemorrhage due to thrombolysis
- Sealed skin…
3. Treatment of increased door vein pressure in cirrhosis
In young children, increased pressure of the veins outside the liver for long periods of time without treatment can lead to cirrhosis of the liver and in designation of liver transplantation. Since the digestive hemorrhage will gradually decrease as the child grows, surgery should be carefully considered. In addition, conservative treatment is affected by many other potential factors.
In patients with cirrhosis of the liver, treatment of increased pressure of the door vein includes: resuscitation treatment, anti-shock, treatment of restoration of blood volume in the veins; hematoma treatment; and prevention of recurrent digestive hemorrhages.
Specifically, the treatment of increased pressure of the door vein in cirrhosis of the liver is as follows:
- Active resuscitation and anti-shock treatment: Treatment is aimed at stabilizing hemolysis. Ensure hemolym by infusion of high molecular solution (Dextran, Hemocel, …), followed by Glucose 5% and blood transfusion. Patients with cirrhosis of the liver should be treated for control of blood clots and thro platelet reduction with fresh plasma infusion or platelet mass. If the treatment of infusions and blood without response, blood pressure does not increase, then take vascular medications such as Dopamine, Noradrenalin, …
- Hematoma treatment: There are 3 hematoma treatments in patients with increased door vein pressure in cirrhosis of the liver: endoscopy put sonde (inserted ball) to prevent bleeding, TIPS technique and self-expanding urethal stent. In particular, the method of endoscopy of inserted balloons is carried out only when the patient's hemolysis stabilizes. If laparoscopic treatment fails, TIPS is in order to treat complications of recurrent digestive hemorrhage. This is an endovascular intervention technique, less invasive, limiting dilated and ruptured veins of the veins of the estodilation, few complications after the intervention, reduced door vein pressure, well-circulating blood, dilated tufts disappearing, no recurrence of digestive hemorrhage.
- Prevention of digestive hemorrhage: In patients with cirrhosis of the liver causing increased pressure of the door vein should be treated for prevention of digestive hemorrhage due to varicose veins of the veins of the veins causing rupture and bleeding. Treatment reduces door vein pressure with vascular medications (Octreotide, Somatostatin, Terlipressin, …) before performing an endoscopy in case of suspected rupture of the vein. After that, treatment of antibiotics (Ceftriaxone, Quinolon), hepatic brain redisperance (Duphalac, Philpovin, …) and some other drugs such as vitamin K, acid secretion reduction, transamin, … In addition, there are a number of surgical methods aimed at preventing recurrent digestive hemorrhages such as surgery to bridge the door vein and the aortic vein with an artificial vein, or spleen and spleen vein removal surgery, renal vein, or Sugiura surgery to separate the veins connecting the door vein and the single vein.
Patients with cirrhosis of the liver that increases door vein pressure should receive concular treatment to limit digestive bleeding that increases the risk of death.
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