According to our doctor, my sister’s son does not have blood vessels between his liver and heart. Is this is serious? His stomach is too large and sometimes he has blood in his stool.
Yes, I am afraid this is a very serious condition, although the part about the missing blood vessels is not exactly right.
Blood leaves the heart through arteries, circulates throughout the body and returns to the heart through veins. The portal vein is one of two main suppliers of blood to the liver. It carries blood from the spleen, intestine and other digestive organs into the liver. When nutrients, toxins and waste products are extracted from the blood, it leaves the liver and flows back to the heart.
Hypertension means high blood pressure. Portal hypertension refers to high blood pressure in the portal vein and its branches. In the United States, portal hypertension is usually caused by cirrhosis, in which liver tissue suffers permanent damage and scarring. The scar tissue blocks the flow of blood into the liver, causing hypertension in the portal vein.
Cirrhosis has many possible causes. By far the most common causes are alcoholism and chronic hepatitis (types B, C or D). When cirrhosis causes portal hypertension, it may lead to numerous symptoms and complications. One of them is a condition called ascites, where fluid accumulates in the abdominal cavity, causing the large stomach that you noticed in your nephew.
The body tries to compensate for the blood flow problems in the portal vein by creating a bypass system, often including so-called collateral blood vessels, one of which may run in the lower portion of the esophagus. These collateral vessels can become swollen and easily ruptured, which causes gastro-intestinal bleeding and possibly blood in the stool.
Cirrhosis has no cure and the damage is irreversible, so treatment aims to prevent further damage and ease symptoms. If alcoholism is the source of cirrhosis, it is imperative that the patient stop drinking. Doctors will try to reduce the portal hypertension with medication. Sometimes surgery is necessary. When liver damage is extreme, a transplant may be the treatment of last resort.