Question

Cirrhosis leads to scarring and increased hydrostatic pressure in the hepatic portal vein. Explain why this increased venous pressure causes net filtration to increase in the hepatic capillaries, leading to ascites (swollen and fluid-filled interstitial space of the abdomen).

Answer 1

Answer:

It is the first complication that usually manifests the cirrhotic patient or with a terminal stage liver disease. It is the loss of fluid in the peritoneal cavity, due to the obstruction in the flow of blood that comes through the portal system, generating what is known as a portal of hypertension and the result of which is this first complication, which can be classified in mild (when only one incidence on salt intake is necessary); moderate (medical treatment is the intake of diuretics); severe (the procedure in these cases is the extraction of the ascitic fluid) and refractory ascites (its indication is a liver transplant). This type of complications can degenerate into bacterial peritonitis, which is when the ascites fluid becomes infected with the body's own bacteria, increasing the morbidity and mortality of patients. Bacterial peritonitis must be treated with antibiotics for a long time.

Explanation:

Another complication derived from portal hypertension is the dilation of the veins in the stomach and esophagus, which can rupture and cause bleeding, due to increased pressure in the portal system. Esophageal varices can manifest in various ways, such as the presence of blood in the stool, massive bleeding with vomiting blood, or significant leakage through the rectum. These complications are generally fatal or may be an indication for liver transplantation, even when liver function is relatively preserved.