Portal vein thrombosis

Portal vein thrombosis is a form of venous thrombosis affecting the hepatic portal vein, which can lead to portal hypertension and reduction in the blood supply to the liver.

Portal vein thrombosis
Portal vein thrombosis seen with computed tomography.
SpecialtyAngiology 

Signs and symptoms

Portal vein thrombosis can cause fever, symptoms of indigestion, and gradually worsening abdominal pain. However, it can also develop without causing symptoms, leading to portal hypertension before it is diagnosed.[1] Other symptoms can develop based on the cause. For example, if portal vein thrombosis develops due to liver cirrhosis, bleeding or other signs of liver disease may be present. If portal vein thrombosis develops due to pylephlebitis, signs of infection such as fever, chills, night sweats may be present.

Causes

Causes can include pancreatitis, cirrhosis, diverticulitis, and cholangiocarcinoma. It is also a known complication of surgical removal of the spleen.[2] and Myeloproliferative disorders. During the last several years, myeloproliferative neoplasms (MPNs) have emerged as a leading systemic cause of SVT (includes PVT)

Diagnosis

The diagnosis of portal vein thrombosis is usually made by ultrasound, computed tomography with contrast or magnetic resonance imaging. D-dimer levels in the blood may be elevated as a result of fibrin breakdown.

Treatment

Portal vein thrombosis on computed tomography (left) and cavernous transformation of the portal vein after 1 year (right)

Treatments include anticoagulants, shunts, bypass surgery, and transplants.

See also

References

  1. Hall, TC; Garcea, G; Metcalfe, M; Bilku, D; Dennison, AR (November 2011). "Management of acute non-cirrhotic and non-malignant portal vein thrombosis: a systematic review". World Journal of Surgery. 35 (11): 2510–20. doi:10.1007/s00268-011-1198-0. PMID 21882035.
  2. Ali Cadili, Chris de Gara, "Complications of Splenectomy", The American Journal of Medicine, 2008, pp 371-375.
Classification
External resources
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