Management of Complications of Portal Hypertension

Acute complications of portal hypertension are common conditions and have poor outcomes, despite the understanding regarding their pathogenesis. Portal hypertension develops when there is resistance to portal blood flow and it worsens as splanchnic blood flow increases. In this context, local release of vascular endothelial growth factor, nitric oxide, and other vasodilators that cause splanchnic arteriolar vasodilation occurs. The systemic repercussion of these changes leads to hypotension, vascular underfilling, and stimulation of endogenous vasoactive systems. As liver function decreases, there is a decrease in albumin synthesis and hyperaldosteronism, factors that are important in the development of ascites. In this issue, there are five articles that refer to the management of acute kidney injury, spontaneous bacterial peritonitis, and variceal bleeding