Portal hypertension and varices: pathophysiology and clinical management

Portal hypertension is a condition that describes increased pressure within the portal vein, an important structure that drains blood from the gastrointestinal tract and conveys it to the liver. This article describes the normal structure of the liver and its circulation. It also explains how cirrhosis leads to the development of portal hypertension and varices, and considers the latest evidence and guidance for safe clinical management. As liver disease is a leading cause of morbidity and mortality, nurses commonly encounter patients experiencing the effects of portal hypertension in practice, and professional bodies have highlighted a need for increased foundational nursing knowledge to enable informed care and optimise patient outcomes. Therefore, this article aims to enhance nurses' knowledge of the underlying pathophysiology, clinical manifestations and recommended management of portal hypertension and varices in the context of end-stage liver disease, with specific consideration of the nurse's role.