Portal hypertension, a consequence of liver failure, causes the formation of collateral channels (varices) leading to life-threatening hemorrhage, ascites (fluid retention), and a complex venous network that complicates surgery.

“and so the what happens is you develop this condition called portal hypertension where the the blood the pressure in the portal venous system increases such that it tries to find other ways back to the heart and so it it forms collateral channels that's those collateral channels are what what form the varices or varicosities that that develop in the gi tract that can lead to life-threatening hemorrhage and liver patients it's what leads to the formation of ascites or the fluid retention that you see in patients with liver disease with these huge protuberant distended abdomens and it also makes the surgical field this kind of rat's nest of collateral venous vessels”