POST-GRADUATE CLINIC Portal Vein Thrombosis – Clinical Profile (original) (raw)

PORTAL VEIN THROMBOSIS — ULTRASOUND IMAGING

Portal venous system, apart from the main portal vein, includes its tributaries: superior and inferior mesenteric vein, as well as splenic vein, so the term portal venous thrombosis encompasses a broad spectrum of pathological conditions. Usually, one or more causative factors can be recognized, either local endothelial/ flow disturbances, or systemic inherited /acquired conditions. Portal vein thrombosis can be associated with benign or malignant disorders. Weather we are speaking about acute or chronic thrombosis, the clinical presentation is different. Acute thrombosis can be presented in a wide range, from mild abdominal discomfort to a state of intestinal ischemia and life-threatening infarction. Chronic thrombosis is usually recognized when variceal bleeding or other symptoms of portal hypertension express. Fast and accurate diagnosis sometimes is a life-saving procedure, especially in acute vascular alterations. Recently, due to the improvement of imaging procedures the number of patients with diagnosed portal vein thrombosis is increasingly growing. With a negative predictive value of 98% color Doppler ultrasound is considered as imaging modality of choice in detecting portal vein thrombosis. Based on large studies it is presumed that overall risk of getting portal vein thrombosis during lifetime is 1% in general population, but much bigger 5%-15% in cirrhotic patients. Existence of specific ultrasound criteria, if fulfilled, has ensured that diagnosis of portal vein thrombosis is fast and non-invasive. Procedure is convenient for the patient and healthcare providers, and above all, allows prompt treatment preventing further deterioration.

Abdominal Pain: An Ominous Sign of Portal Vein Thrombosis—Case Series

OALib

Portal vein thrombosis (PVT) is a disease in which thrombosis occurs from the intrahepatic branches of the portal vein and may extend to the splenic vein and/or superior mesenteric vein. It is most often associated with liver cirrhosis. PVT not associated with cirrhosis is rare. The aim of this case series of portal vein thrombosis is to give importance that even though PVT is a rare cause of abdominal pain, timely diagnosis, and appropriate management is vital due to its lethal complications such as mesenteric ischemia and mesenteric infarction and late complication like portal hypertension.

Portal vein thrombosis as a rare cause of abdominal pain: When should we think?

Turkish Journal of Surgery, 2015

Extrahepatic portal vein thrombosis (PVT) is a rare condition that is characterized by the presence of thrombus within any segment of the portal vein, including the right and left intrahepatic branches. It may also extend to the splenic or superior mesenteric veins. Portal vein thrombosis may be related to cirrhosis or liver malignancy as well as to local inflammatory conditions in the abdomen and genetic or acquired thrombophilic diseases. Currently, PVT is being increasingly diagnosed due to advances in modern imaging techniques. The clinical presentation has a wide range, from an asymptomatic lesion to a potentially life-threatening situation. In this study, we present three patients with PVT. The diagnosis was made by radiologic and clinical findings. In the first patient, genetic testing revealed factor V Leiden mutation as the cause of PVT. The second patient was diagnosed with lupus anticoagulant syndrome as the cause of PVT. Portal vein thrombosis was associated with intra abdominal infection due to anastomotic leakage in the third patient. Two patients were successfully treated with anticoagulant therapy. This report emphasizes that even though PVT is a rare cause of abdominal pain, timely diagnosis and appropriate management is vital due to its lethal complications such as mesenteric ischemia and mesenteric infarct.

Portal vein thrombosis as a rare cause of abdominal pain: When to consider?

2017

Duplex sonography and colour Doppler in the diagnosis and follow-up of portal vein thrombosis

European Journal of Ultrasound, 1996

Clinical findings in acute portal vein thrombosis are often limited and non-specific. Many portal vein thromboses probably remain undiagnosed during the acute stage, and some of these may be discovered later because of complications such as variceal bleeding. Ultrasound with pulsed Doppler and colour Doppler is useful in the diagnosis of the thrombus, and for evaluation of its extension, hemodynamic significance and complications. We present a case of acute portal vein thrombosis associated with protein S deficiency, and review the findings of ultrasound and Doppler in the light of those previously reported. We describe the lack of Doppler signal in the splenic vein and inability to visualize the portal vein and its intra-hepatic branches as one normally can. Further observations include a thrombosed portal vein branch within the liver, prominent branches of the hepatic artery, splenomegaly, partial recanalization and development of collaterals. In the hepatic veins, we found pathologic blood flow with reduced heart-synchronous variations of velocity, as often found in portal hypertension due to cirrhosis. This is not previously reported in portal vein thrombosis, and may be a sign of a portal vein thrombosis with a large degree of obstruction to blood flow and development of portal hypertension. This phenomenon can be explained using hemodynamics.

Portal vein thrombosis; risk factors, clinical presentation and treatment

BMC Gastroenterology, 2007

Background: Portal vein thrombosis (PVT) is increasingly frequently being diagnosed, but systematic descriptions of the natural history and clinical handling of the condition are sparse. The aim of this retrospective study was to describe risk factors, clinical presentation, complications and treatment of portal vein thrombosis in a single-centre.

Portal vein thrombosis (PVT): A study of 20 non-irrhotic cases

Swiss medical weekly: official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology

Portal and mesenteric venous thrombosis (PVT) is an uncommon disease with serious consequences if not discovered early in order to prevent complications such as variceal bleeding and intestinal ischaemia. The objective of this study was to describe the clinical presentation and outcome of patients with PVT with a view to early diagnosis and treatment of this disease. The study was restricted to patients with PVT not caused by underlying liver cirrhosis. To analyse important clinical characteristics of this entity we performed a retrospective study of 20 non-cirrhotic patients seen in our hospital from February 1998 to March 2003. The main clinical symptom was abdominal pain (13 patients, 86%), sometimes in combination with diarrhoea and vomiting (5 patients, 33%), nausea and anorexia (3 patients). Laboratory signs were non-specific and diagnosis was usually by computed tomography (19 patients, 95%). Causative factors included prothrombotic states (9 patients, 45%) and/or local facto...

Portal Vein Thrombosis: A Case report and Literature Review

A case report of Portal Vein Thrombosis (PVT) as a complication of protein S deficiency. PVT has been increasingly diagnosed over the years, particularly through the use of ultrasound-Doppler equipment. The lifetime risk of getting PVT in the general population has recently reported to be 1%.1 While this condition has traditionally been associated with cirrhosis or liver malignancy, it may also occur without any liver disease. The case report is followed by a discussion of the aetiology and clinical presentations of PVT, as well as a review of the investigations and management proposed in the literature.

POST-GRADUATE CLINIC Portal Vein Thrombosis – Clinical Profile (original) (raw)

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