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.
Зміст
Historical Perspective.- Portal Hypertension.- Pathobiology and Experimental Progress in Portal Hypertension.- Anatomy and Vascular Biology of the Cells in the Portal Circulation.- Cell and Molecular Mechanisms of Increased Intrahepatic Resistance and Hemodynamic Correlates.- Molecular Mechanisms of Systemic Vasodilation and Hyperdynamic Circulatory State of Cirrhosis.- Mechanisms of Sodium Retention, Ascites Formation, and Renal Dysfunction in Cirrhosis.- Hepatic Hemodynamics in Portal Hypertension.- Neovascularization, Angiogenesis, and Vascular Remodeling in Portal Hypertension.- Mechanisms of Cardiopulmonary Hemodynamics and Dysfunction in Portal Hypertension.- Methodology to Assess Portal Hypertension in Humans.- Measurement of Hepatic Venous Pressure Gradient.- Evaluation of Portal Hemodynamics Using Indicator Dilution and Noninvasive Techniques.- Endoscopic Assessment of Portal Hypertension Including Variceal Pressure Measurements.- Natural History and Treatment of Esophageal Varices.- Clinical Features and Natural History of Variceal Hemorrhage.- Management Strategies for the Prophylaxis and Treatment of Esophageal Variceal Rupture.- Pharmacologic Therapy for Management of Esophageal Varices.- Endoscopic Treatment for Bleeding Esophageal Varices.- Surgical Therapies for Management.- Transjugular Intrahepatic Portosystemic Stent-Shunt.- Clinical Features and Management of Gastric Varices, Portal Hypertensive Gastropathy, and Ectopic Varices.- Natural History and Treatment of Ascites and Hepatorenal Syndrome.- Ascites.- Management of Ascites.- Spontaneous Bacterial Peritonitis and Other Infections in Cirrhosis.- Diagnosis and Management of the Hepatorenal Syndrome.- Evaluation and Treatment in Special Circumstances of Portal Hypertension.- Pregnancy and Portal Hypertension.- Causes and Management of Portal Hypertension in the Pediatric Population.- Noncirrhotic Portal Hypertension and Portal Vein Thrombosis.- Hepatic Venous Outflow Obstruction.- Pulmonary Complications Associated with Portal Hypertension.- Health Status Assessment and Economic Analyses in Cirrhosis and Portal Hypertension.- Future Treatments.
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