Caused by blood being forced down alternate channels by the increased resistance to flow through the systemic venous system rather than the portal system. They include:
- Ascites (free fluid in the peritoneal cavity).
- Hepatic encephalopathy.
- Increased risk of spontaneous bacterial peritonitis.
- Increased risk of hepatorenal syndrome.
- Splenomegaly (enlargement of the spleen) with consequent sequestration therein of red blood cells, white blood cells, and platelets, together leading to mildpancytopenia.
- Portacaval anastomoses: Esophageal varices, gastric varices, anorectal varices (not to be confused with hemorrhoids), and caput medusae. Esophageal and gastric varices pose an ongoing risk of life-threatening hemorrhage, with hematemesis or melena.