Physiopathologie de l'hypertension portale : mise à jour

Portal hypertension is characterised by a hyperdynamic circulation secondary to a systemic arteriolar dilation that occurs despite activated vasopressor system. One of the major consequences is the development of portal-systemic collateral vessels. Portal pressure, varicose pressure and portal blood flow can be measured. Techniques for indirect measurement are not yet validated. Nitric oxide plays a central role in the reduction of systemic vascular resistances however other vasoactive mediators such as endothelin, angiotensin and prostaglandins also are involved. The molecules that can induce intrahepatic release of nitric oxide or inhibition of endothelin receptors are very promising in a new therapeutic approach of portal hypertension.