Portal hypertension is defined as elevation of the hepatic venous pressure gradient to >5 mmHg, which occurs as a consequence of cirrhosis (Chap. 157 Cirrhosis and Alcoholic Liver Disease). It is caused by increased intrahepatic resistance to the passage of blood flow through the liver due to cirrhosis together with increased splanchnic blood flow due to vasodilatation within the splanchnic vascular bed.
The primary complications of portal hypertension are gastroesophageal varices with hemorrhage, ascites (Chap. 45 Ascites), hypersplenism, hepatic encephalopathy, spontaneous bacterial peritonitis (Chap. 45 Ascites), hepatorenal syndrome (Chap. 45 Ascites), hepatocellular carcinoma (Chap. 72 Tumors of the Gastrointestinal Tract).