1. Neoplasms
Portal
Hypertension
Clinical Surgery Department
Dr. Benjamin Robles Madrigal
Dr. Hector Manuel Vírgen Ayala
Francisco Javier Robles Saucedo

2. Neoplasms
Bening
Malignant
Metastatic
Cyst

3. Liver Cell Adenoma
women (11:1)
20-40 years old
OCPs
70% lonely
Soft
Yellow
2-15cm
Glycogen & Fat
(intracellular)

4. Liver Cell Adenoma
Abdominal pain
(hemorrhage or
compresion)
Dx.
MRI
CT
Biopsy
Tx
Resection
Resection + Embolization
(Hemorrhage)

5. Focal Nodular
Hyperplasia
Women
40 years old
80% lonely
5 – 10 cm
Central Star-
Shaped Scar

6. Focal Nodular
Hyperplasia
Abdominal pain
(rarely)
Dx.
CT
MRI
Tx
Resection

7. Hemangioma
Most common
Women 3:1 (45 years
old)
Cavernous.
< 5cm
Asyntomatic
Dx
CT + Contrast
MRI
Tx
Resection
Radiotherapy
Embolization

8. Hepatocellular
Carcinoma
1-3:100,000
Men (2-8:1) 50-60 Risk Factors:
years old Cirrhosis
Smoking
Alcohol
Contraceptives
VHB & VHC

9. Hepatocellular
Carcinoma
Symtomps
Abdominal pain
weight loss
Anorexy
Nausea
Budd-Chiari Syndrome
Jaundice
Hemobilia

10. Hepatocellular
Carcinoma
Dx.
CT
MRI
ECO
Angyography
AFP
Bx

11. Hepatocellular
Carcinoma
Tx.
Qx
Hepatectomy
Ablative
Ethanol Inyection
Thermal Ablation
Transarterial
Embolization
Combinated
External Radiation
Sistemic
Chemotherapy
Inmunotherapy

12. Portal
Hypertension
Portal Vein Pressure > 10 mm Hg
Flow Resistance
Pre - Hepatic (Obstruction)
Hepatic (Cirrhosis, Hepatitis)
Post – Hepatic (Sx. Budd – Chiari)
Portal Circulation (>1350 ml/min)
Porto-arterial Fistula
Splenic circulation increment
(Sx. Banti)

13. Portal
Hypertension
Tx.
Shunts
Ballon Tamponande
TIPS (Transjugular
intrahepatic portosystemic
shunt)
Vasopressin
Liver Transplant
Endoscopic
Schlerotherapy.