Question

GASTROINTESTINAL Case #1 Patient Profile: A 34 year old male with history of alcoholic cirrhosis and portal hypertension is admitted to the hospital. Objective Data: • Eyes: sclerae jaundiced bilateral Neurologic: alert and oriented Cardiovascular: blood pressure 120/76, heart rate 78 Pulmonary: respiration 12 per minute Abdomen: distended with hepatomegaly Skin: jaundiced, warm and dry . • Critical Thinking Questions: 1. Explain the process by which portal hypertension leads to ascites. 2. Discuss the mechanism for the change in color in his eyes and skin? After admission, he develops hematemesis and becomes hypotensive and tachycardic. He is determined to have ruptured esophageal varices. 3. How is this causing his low blood pressure and increased heart rate?

Answer 1

Portal hypertension occurs when cells liver become damaged and body cannot repair them,human body carries bllod to liver through a large blood vessels called portal vein .Cirrhosis slows blood flow and putsstress on portal vein,this causes high blood pressure known as portal hypertension.Ascities is acollection of fluid in the tummy (abdomen) portal hypertension can cause this because the high blood pressure in the blood vessels pushes fluid out of these blood vessels into the space between the organs.

          The changes of yellow colour in eyes and body due to jaundice.It caused by liver problems and is caused by high levels of bilirubin .Jaundice occurs when the oxygen carrying components in the blood ,called hemoglobin break down in to bilirubin and human body dosent clear bilirubin,Bilirubin is supposed to move from the liverto the bile duct.

   Esophaggeal varices usually occur in people who have liver disease because of the bleeding cause blood pressure will low and the heart rate will increase,bleeding esophageal varcirs are life threatening.